The effect of remission of poststroke depression on activities of daily living in a double-blind randomized treatment study.

Abstract

Poststroke depression has been associated with impaired recovery of activities of daily living (ADL) during the first 2 years after stroke. This study examined the effect of remission of poststroke depression on recovery in ADL in a double-blind randomized treatment study. Based on a semistructured psychiatric exam and DSM-IV diagnostic criteria, a consecutive series of 23 patients who met criteria for major depression (N = 16) or minor depression (N = 7) were selected and randomly assigned to either active treatment (nortriptyline) or placebo. Functional physical (i.e., ADL) impairment was assessed using the Johns Hopkins Functioning Inventory (JHFI). Patients whose depressive disorder remitted at follow-up had significantly greater recovery in ADL functions compared with patients whose depression did not remit. There were no differences in demographic variables, lesion characteristics, and neurological symptoms between the two groups, which would explain the significantly greater improvement among the remitted patients. Because both major and minor depression patients who remitted showed greater improvement in ADL than nonremitted patients some of whom were treated with active and some with placebo medication, nonpharmacotherapeutic mechanisms related to recovery from depression appear to mediate this enhanced recovery.

• Authors: E Chemerinski, R G Robinson, S Arndt, J T Kosier
• Journal: The Journal of nervous and mental disease (J Nerv Ment Dis) Vol. 189 Issue 7 Pg. 421-5 (Jul 2001) ISSN: 0022-3018 [Print] United States
• PMID: 11504318 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antidepressive Agents, Tricyclic
• Placebos
• Nortriptyline

Topics

• Activities of Daily Living (psychology)
• Adult
• Aged
• Antidepressive Agents, Tricyclic (therapeutic use)
• Depressive Disorder (diagnosis, drug therapy, etiology)
• Double-Blind Method
• Female
• Follow-Up Studies
• Health Status Indicators
• Hospitalization
• Humans
• Male
• Middle Aged
• Nortriptyline (therapeutic use)
• Personality Inventory (statistics & numerical data)
• Placebos
• Stroke (complications, psychology)
• Surveys and Questionnaires
• Treatment Outcome