机构：[1]Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[2]China National Clinical Research Center of Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China,[4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China,[5]Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China,[6]Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China,[7]The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
Objectives: This study aimed to examine the rate of remission in individuals experiencing early-onset poststroke depression (PSD) in China and to identify predictors of remission during a 3-month follow-up. This study also explored the interaction between cognitive impairment and depression. Methods: A total of 820 patients with PSD from a massive multicenter prospective cohort project in China (PRIOD) were included in the present study. Depressive symptoms were measured with the Hamilton Depression Rating Scale (17 Items, HDRS-17) at 2 weeks and the endpoint of the 3-month follow-up. The cut-off score of HDRS-17 (<8) was used to define remission of depression at the endpoint. The Mini-Mental State Exam (MMSE) was used to evaluate the cognitive impairment of the patients (at the 2-week follow-up and 3-month endpoint). The National Institutes of Health Stroke Scale (NIHSS) was used to measure the severity of stroke. Results: (1) Six hundred and forty-two patients completed the 3-month follow-up, and 332 (51.7%) patients remitted by the end of the study. Univariate analyses indicated that there was a higher proportion of patients who had hypertension, frontal lobe lesion, basal ganglia lesion, poor outcome at 2 weeks, high scores on the NIHSS at 2 weeks, major life events within 3 months, and major medical diseases within 3 months in the nonremission group. In stepwise multiple logistic regression analyses, remission was significantly predicted by lower NIHSS scores at 2 weeks (p = 0.001, OR = 1.086, 95% CI 1.035-1.139), fewer major life events (p = 0.036, OR = 5.195, 95% C11.111-27.283), fewer major medical comorbidities (p = 0.015, OR = 2.434, 95% CI 1.190-4.979), and fewer frontal lobe lesions (p = 0.042, OR = 1.717, 95% CI 1.019-2.891). (2) After controlling for confounding variables, repeated measures analysis of variance revealed a significant interaction between time (2 weeks vs. 3 months) and group (remitters vs. nonremitters) on MMSE scores [F-(1,F-532) =20.2, p < 0.001]. Conclusions: Early-onset PSD patients with milder neurological impairment, fewer major life events, fewer major medical comorbidities and no frontal lobe lesion at baseline were more likely to achieve remission 3 months after stroke. Only remitters of PSD improved significantly in cognitive impairment after stroke.
基金：
National Key Research & Development Program of China [2016YFC1307200]; National Key Technology Research and Development Program of the Ministry of Science and Technology of ChinaNational Key Technology R&D Program [2015BAI13B03]; Beijing Brain Research [Z161100000216131]; Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z151100004015127]; National 11th 5-year Scientific and Technological Brainstorm Project [2006BA101A11]; Build High Level Technology Talents of Health System in Beijing [2015-3-038]; Beijing Municipal Administration of Hospitals' Youth Programme [QML20161902]
第一作者机构：[1]Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[2]China National Clinical Research Center of Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China,[4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China,
共同第一作者：
通讯作者：
通讯机构：[1]Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[2]China National Clinical Research Center of Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,[3]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China,[4]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China,[5]Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China,[6]Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, Capital Medical University, Beijing, China,[7]The National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Jing Huang,Fu-Chun Zhou,Boyuan Guan,et al.Predictors of Remission of Early-Onset Poststroke Depression and the Interaction Between Depression and Cognition During Follow-Up[J].FRONTIERS IN PSYCHIATRY.2019,9(JAN):-.doi:10.3389/fpsyt.2018.00738.
APA：
Jing Huang,Fu-Chun Zhou,Boyuan Guan,Ning Zhang,Anxin Wang...&Chunxue Wang.(2019).Predictors of Remission of Early-Onset Poststroke Depression and the Interaction Between Depression and Cognition During Follow-Up.FRONTIERS IN PSYCHIATRY,9,(JAN)
MLA：
Jing Huang,et al."Predictors of Remission of Early-Onset Poststroke Depression and the Interaction Between Depression and Cognition During Follow-Up".FRONTIERS IN PSYCHIATRY 9..JAN(2019):-
