Differences in Therapeutic Responses and Factors Affecting Post-Stroke Depression at a Later Stage According to Baseline Depressionopen access
- Authors
- Lee, Eun-Jae; Kim, Jong S.; Chang, Dae-Il; Park, Jong-Ho; Ahn, Seong Hwan; Cha, Jae-Kwan; Heo, Ji Hoe; Sohn, Sung-Il; Lee, Byung-Chul; Kim, Dong-Eog; Kim, Hahn Young; Kim, Seongheon; Kwon, Do-Young; Kim, Jei; Seo, Woo-Keun; Lee, Jun; Park, Sang-Won; Koh, Seong-Ho; Kim, Jin Young; Choi-Kwon, Smi; Kim, Min-Sun; Lee, Ji Sung
- Issue Date
- May-2018
- Publisher
- KOREAN STROKE SOC
- Keywords
- Depression; Stroke; Escitalopram; Anger; Emotional incontinence
- Citation
- JOURNAL OF STROKE, v.20, no.2, pp 258 - +
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF STROKE
- Volume
- 20
- Number
- 2
- Start Page
- 258
- End Page
- +
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/3602
- DOI
- 10.5853/jos.2017.02712
- ISSN
- 2287-6391
2287-6405
- Abstract
- Background and Purpose The pathophysiology of post-stroke depression (PSD) is complex and may differ according to an individual's mood immediately after stroke. Here, we compared the therapeutic response and clinical characteristics of PSD at a later stage between patients with and without depression immediately after stroke. Methods This study involved a post hoc analysis of data from EMOTION (ClinicalTrials.gov NCT01278498), a placebo-controlled, double-blind trial that examined the efficacy of escitalopram (10 mg/day) on PSD and other emotional disturbances among 478 patients with acute stroke. Participants were classified into the Baseline-Blue (patients with baseline depression at the time of randomization, defined per the Montgomery-Asberg Depression Rating Scale [MADRS]>= 8) or the Baseline-Pink groups (patients without baseline depression). We compared the efficacy of escitalopram and predictors of 3-month PSD (MADRS >=) between these groups. Results There were 203 Baseline-Pink and 275 Baseline-Blue patients. The efficacy of escitalopram in reducing PSD risk was more pronounced in the Baseline-Pink than in the Baseline-Blue group (P for interaction=0.058). Several risk factors differentially affected PSD development based on the presence of baseline depression (P for interaction <0.10). Cognitive dysfunction was an independent predictor of PSD in the Baseline-Blue, but not in the Baseline-Pink group, whereas the non-use of escitalopram and being female were more strongly associated with PSD in the Baseline-Pink group. Conclusions Responses to escitalopram and predictors of PSD 3 months following stroke differed based on the presence of baseline depression. Our data suggest that PSD pathophysiology is heterogeneous; therefore, different therapeutic strategies may be needed to prevent PSD emergence following stroke.
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- Appears in
Collections - 2. Clinical Science > Department of Neurology > 1. Journal Articles
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