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[Clinical course of post-stroke depression in Kinshasa]
M Mpembi Nkosi1, S Mampunza Ma Miezi2, V Massamba Kubuta3
1Département de psychiatrie, université catholique de Louvain, institut de recherche santé publique, santé et société, place de l'Université 1, 1348 Louvain-La-Neuve, Belgique; Département de psychiatrie, université de Kinshasa, Lemba, Kinshasa, Congo.
Objectives:
To describe the evolution of the clinical profile of post-stroke depression over a period of one year and to determine factors associated with changes in post-stroke depression.
Methods:
Prospective cohort study with a follow-up of 1year including 30 consecutive eligible patients. The severity of depression was assessed with the patient health questionnaire (PHQ9).
Results:
The mean age was 55.87±12.67years. Seventy percent of patients were men. The two assessments for neurological status, perceived health status and test results of attention were not statistically different. The rate of depressive symptoms was 26.67% in 2011 and 20% in 2012. Disability and apathy were significantly improved. The average for disability increased from 2.77±1.19 to 2.46±2.19 (P=0.002). From 66.7% in 2011, the proportion of patients able to walk without assistance rose to 93.3% in 2012 (P=0.03). In addition, the proportion of patients apathetic decreased from 43.3% to 13.3% (P=0.01). Greater age, female sex, sleep disorders and post-stroke apathy remained associated with DPAVC between the two assessments, with an increase in the strength of the association for apathy.
Conclusions:
The frequency of post-stroke depression is high and remains stable over time. Disability is the clinical feature that evolved more favorably. The association with apathy, present at the beginning, of the study was strengthened one year later.