Early apathetic, but not depressive, symptoms are associated with poor outcome after stroke

冷漠 医学 危险系数 萧条(经济学) 内科学 冲程(发动机) 优势比 置信区间 抑郁症状 物理疗法 精神科 焦虑 疾病 机械工程 工程类 经济 宏观经济学
作者
Anna Maria Lopatkiewicz,Joanna Pera,Agnieszka Słowik,Tomasz Dziedzic
出处
期刊:European Journal of Neurology [Wiley]
卷期号:28 (6): 1949-1957 被引量:15
标识
DOI:10.1111/ene.14785
摘要

Abstract Background and purpose Depression and apathy are frequent neuropsychiatric disturbances after stroke and may appear together. Despite the overlap in symptoms between poststroke depression and apathy, these two syndromes might be associated with different prognoses and benefit from different treatments. We aimed to disentangle the relationship between early depressive and apathetic symptoms and outcome after stroke. Methods Of 698 enrolled patients with ischemic stroke, we included 443 participants (median age = 69 years, 51% female) who underwent depressive and apathetic symptom assessment on Day 8 after stroke. We divided patients into four groups: without greater depressive and apathetic symptoms (Group 1), with only apathetic symptoms (Group 2), with only depressive symptoms (Group 3), and with both depressive and apathetic symptoms (Group 4). Results After adjusting for age and stroke severity, Group 2 and Group 4 had an increased risk of poor 3‐month outcome (odds ratio [OR] = 1.98, 95% confidence interval [CI] = 1.16–3.38, p = 0.01 and OR = 1.58, 95% CI = 1.24–2.01, p < 0.01, respectively). Group 2 and Group 4 also had an increased risk of poor 12‐month outcome (OR = 3.85, 95% CI = 2.19–6.78, p < 0.01 and OR = 1.54, 95% CI = 1.22–1.96, p < 0.01, respectively) and mortality (hazard ratio [HR] = 2.76, 95% CI = 1.19–6.41, p = 0.02 and HR = 1.77, 95% CI = 1.32–2.38, p < 0.01, respectively). Compared with Group 1, Group 3 did not have an increased risk of unfavorable outcomes. Conclusions Early apathetic, but not depressive, symptoms are related to worse outcomes after stroke. Our study underscores the importance of recognizing apathetic symptoms independently from depressive symptoms.
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