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Validity of evaluation scales for post-stroke depression: a systematic review and meta-analysis
Fang Liu1, Lei Gong2, Huan Zhao1
1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
BMC Neurology
|August 15, 2024
Summary
The Patient Health Questionnaire-9 (PHQ-9) and Hamilton Depression Scale (HDRS) are recommended for assessing post-stroke depression (PSD). These scales offer accurate and efficient diagnosis and follow-up for stroke patients.
Area of Science:
- Neurology
- Psychiatry
- Clinical Assessment
Background:
- Post-stroke depression (PSD) significantly worsens stroke prognosis.
- Accurate identification and assessment of PSD present challenges.
- Need for straightforward, accurate, efficient, and reproducible diagnostic tools for PSD.
Purpose of the Study:
- To identify validated scales for PSD diagnosis, assessment, and follow-up.
- Evaluate the accuracy, efficiency, and reproducibility of different assessment scales.
Main Methods:
- Systematic literature search across 7 electronic databases.
- Inclusion of studies published from January 1985 to December 2023.
- Analysis of 32 studies to determine scale performance.
Main Results:
- Patient Health Questionnaire-9 (PHQ-9) and Hamilton Depression Scale (HDRS) show high diagnostic accuracy for PSD.
- PHQ-9 (any depression): sensitivity 0.82, specificity 0.87.
- HDRS (major depression): sensitivity 0.92, specificity 0.89.
- Both scales demonstrated accuracy in acute and chronic stroke phases.
- No definitive scales identified for PSD with aphasia or cognitive impairment.
Conclusions:
- Recommends PHQ-9 and HDRS for PSD assessment.
- HDRS shows high diagnostic performance and can substitute structured interviews.
- Further research needed for PSD assessment in patients with aphasia and cognitive impairment.
