Depression Improvement Is Related to Social Role Functioning After Stroke

Schmid AA, Damush T, Tu W, Bakas T, Kroenke K, Hendrie HC, Williams LS. Depression improvement is related to social role functioning after stroke.ObjectivesTo (1) examine the relationships between baseline demographic, clinical, and psychological characteristics and social role functioning (SRF) at 4 months after stroke, and (2) assess whether depression improvement is associated with 4-month SRF.DesignWe completed a secondary data analysis using data from a completed cohort study including people with stroke with or without depression. We used multiple linear regression to identify variables independently associated with 12-week SRF.SettingHospital and patients' homes. The intervention was via phone calls.ParticipantsPeople with a new stroke recruited during the inpatient stay (N=371, depressed only n=176). All survived an ischemic stroke, were 18 years and older, spoke and understood English, owned a telephone, had no severe language or cognitive impairments, and were expected to live at least 6 months.InterventionsNot applicable.Main Outcome MeasuresWe measured depression with the Patient Health Questionnaire-9 (PHQ-9), and depression improvement was defined by a 50% decrease in PHQ-9 scores from baseline to 12 weeks or a 12-week PHQ-9 score <10. SRF was measured with the social domain of the Stroke-Specific Quality of Life Scale.ResultsDepression and comorbidities were found to be independently associated with 12-week SRF. Importantly, depression response (or depression improvement) was the only variable to independently predict SRF in the depressed-only group.ConclusionsAmong stroke survivors with depression, improvement of that depression was independently associated with improved SRF. This is a reminder of the importance for rehabilitation providers to screen for and treat poststroke depression.