Dr. L. L. Amila Isuru

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PREVALENCE AND CORRELATES OF POST STROKE DEPRESSION AT A STROKE UNIT IN A TERTIARY CARE HOSPITAL IN SRI LANKA

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Slide1:

PREVALENCE AND CORRELATES OF POST STROKE DEPRESSION AT A STROKE UNIT IN A TERTIARY CARE HOSPITAL IN SRI LANKA Isuru LLA, Samarasinghe SNP, Fonseka TPM, U Ranawaka , A Hapangama Colombo North Teaching Hospital , Sri Lanka

Prevalence and Correlates of Post Stroke Depression at a Stroke Unit in a Tertiary Care Hospital in Sri Lanka :

Prevalence and Correlates of Post Stroke Depression at a Stroke Unit in a Tertiary Care Hospital in Sri Lanka Isuru LLA 1 , Samarasinghe SNP 2 , Fonseka TPM 2 , U Ranawaka 4 , A Hapangama 5

Introduction :

Introduction Post stroke depression (PSD) with prevalence figures between 20%-50% is one of the commonest psychiatric disability / complications of stroke.

Introduction cont….:

Introduction cont…. Post stroke depression results in Poorer rehabilitation outcomes More functional disability Higher mortality Increased possibility of a re-stroke Poor adherence to lifestyle modifications and medications Depression as an independent risk factor for stroke (Pan A et al. 2011)

Introduction cont….:

Introduction cont…. Post stroke depression affects the quality of life Early screening, detection and effective treatment of PSD is necessary to facilitate the recovery process

Objectives :

Objectives To determine the prevalence, demographic and clinical correlates of PSD in patients at a stroke unit in a tertiary care hospital in Sri Lanka.

Study setting :

Study setting Stroke unit attached to the university medical unit at the Colombo North Teaching Hospital 8 bedded unit Multidisciplinary team Neurologist Psychiatrist Physiotherapist Occupational therapist Nursing staff Speech therapist

Study setting cont…:

Study setting cont… After the initial management of patients Discharged from the stroke unit Transferred to Rheumatology and Rehabilitation Hospital, Ragama

Method :

Method A retrospective as well as prospective study design Total of 168 patients participated in the study Information gathered from the Bead Head Tickets of all the patients admitted to stroke unit upto 31.12.2014 All eligible patients admitted to stroke unit since 01.01.2015 All patients underwent an assessment by a psychiatrist as part of their routine assessment.

Method cont…. :

Method cont…. ICD 10 criteria for depression was administered among all consenting patients at the stroke unit of Colombo North Teaching Hospital. Clinical information relating to patients, including the side of the stroke was obtained from the bed head ticket. Patients diagnosed with post stroke depression were started on treatment.

Slide11:

Data was analyzed using Chi squared test and multivariate analysis.

Results :

Results Prevalence of depression was 26.2%

Results cont….:

Results cont…. Sex distribution (p>0.05)

Results cont….:

Results cont …. Age distribution (p>0.05)

Results cont….:

Results cont…. Educational level (p>0.05)

Results cont….:

Results cont…. Occupational status (p<0.05)

Results cont….:

Results cont…. Presence of substance use (p>0.05)

Results cont….:

Results cont…. Side of the lesion (p>0.05)

Results cont….:

Results cont…. Presence of dysarthria (p<0.05)

Results cont….:

Results cont…. There was no statistically significant correlation between developing PSD and Sociodemographic factors (age, gender, marital state, occupation and level of education) Medical and or psychiatric history Lesion related parameters

Results cont….:

Results cont…. Association of depression with the side of the lesion was not statistically significant. Risk of depression related to the location of the stroke, being associated with a left anterior or right posterior hemisphere stroke ( Starkstein and Robinson, 1993).

Results cont….:

Results cont…. Odds of having depression was 2.4 times higher among patients who had post stroke dysarthria (P<0.001) 1.9 times higher among patients who were unemployed

Conclusions :

Conclusions After acute stroke, severe depression was seen in 26.2% of patients who needed psychiatric intervention. Rates of depression related to laterality of the lesion found no effect. Significant correlation with PSD was seen in patients with unemployment and post stroke dysarthria.

Limitations :

Limitations Retrospective study design Lack of follow up of patient Level of disability at the time of presentation was not included in the study

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Thank You.

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