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Abstract Details

Box Checking for Comprehensive Stroke Care Metrics of Depression Screening: Does it Actually Equate to Better Treatment
Cerebrovascular Disease and Interventional Neurology
P16 - Poster Session 16 (5:30 PM-6:30 PM)
4-003
One in three stroke patients develop depression. The exact cause of post stroke depression has been debated but may be due to brain injury resulting from stroke and psychological factors. We aimed to 1) Discover frequency of patients suffering from depressive symptoms post-stroke 2) Ascertain whether occurrence of post stroke depression plays a role in adherence to follow up appointment 3) Determine the frequency of antidepressant treatment initiation and 4) Identify location of stroke most commonly associated with depression.
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We conducted a single institution, retrospective chart review of patients 18 years and older, discharged with ischemic stroke from October 2017 - March 2018. Variables such as age, sex, location of stroke, discharge PHQ9 score, depression treatment and follow up appointment adherence were determined. 

In 200 patients (48.5% M, 51.5% F), 28 (14.0%) had pre-existing diagnosis of depression. The mean PHQ9 on discharge was 5.32±5.16 (n=145), with 66 (45.5%) of patients having PHQ9≥5 at discharge, indicating at least mild depressive symptoms. Females were twice as likely to experience at least mild depressive symptoms (66.7% F vs 33.3% M,  p=0.002). Only 19 patients with PHQ9≥5 at discharge patients were started or continued on antidepressants. On subgroup analysis of patients with PHQ9≥5, the most common locations of stroke were right parietal (20, 30.3%), left subcortical (14, 21.2%) and right frontal (13, 19.6%). No association was found between discharge PHQ9 score and follow up appointment adherence.

 

 
PHQ9 scores irrespective of treatment do not play a predictive role in follow up appointment adherence. Females were more likely than males to experience post stroke depression; and while depressive symptoms are common, patients were unlikely to be prescribed antidepressant therapy. The most common location of stroke associated with depression was right parietal lobe. Such patients should be assessed closely for symptoms of depression with standardized screening tools.
Authors/Disclosures
Parneet K. Grewal, MD
PRESENTER 		The institution of Dr. Grewal has received research support from Bristol Myer Squibb Foundation. The institution of Dr. Grewal has received research support from IPSEN Global.
Ray Mirembo No disclosure on file
No disclosure on file
Jessica D. Lee, MD, FAAN (University of Kentucky) Dr. Lee has received personal compensation for serving as an employee of 好色先生. The institution of Dr. Lee has received research support from Janssen.