Approximately one-third of stroke survivors have symptoms of depression. A better understanding of the early risk factors implicated in this form of comorbidity may contribute to the development of early prevention strategies and to improving outcomes for this population. The current study uses ecological momentary assessment techniques to identify behavioral risk factors for depression 3 months after stroke. Thirty-six participants completed ambulatory monitoring of daily life circumstances (location, social environment, and activity) 5 times per day during a 1-week period after hospital discharge. Clinician-administered measures of depression were also provided before discharge and 3 months later. Ambulatory monitoring revealed that depression scores at 3 months were lower among individuals with more social interactions but higher among those who reported having sports activities and working in the week following hospital discharge. Daily life behaviors may have important implications for understanding the risk of poststroke depression, and mobile technologies may provide important contributions to their investigation.
World Health Organization. In: World Health Organization, ed. The Global Burden of Disease: 2004 Update. 2008:35. WHO Press, World Health Organization: Geneva, Switzerland.
2.
HackettMLYapaCParagVAndersonCS. Frequency of depression after stroke: a systematic review of observational studies. Stroke. 2005;36(6):1330–1340.
3.
KouwenhovenSEKirkevoldMEngedalKKimHS. Depression in acute stroke: prevalence, dominant symptoms and associated factors. A systemactic literature review. Disabil Rehabil. 2011;33(7):539–556.
4.
MorrisPLRobinsonRGAndrzejewskiPSamuelsJPriceTR. Association of depression with 10-year poststroke mortality. Am J Psychiatry. 1993;150(1):124–129.
5.
SturmJWDonanGADeweyHMQuality of life after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS). Stroke. 2004;35(10):2340–2345.
6.
JeongBOKangHJBaeKYDeterminants of quality of life in the acute stage following stroke. Psychiatry Investig. 2012;9(2):127–133.
7.
KishiYKosierJTRobinsonRG. Suicidal plans in patients with acute stroke. J Nerv Ment Dis. 1996;184(5):274–280.
8.
PompiliMVenturiniPCampiSDo stroke patients have an increased risk of developing suicidal ideation or dying by suicide? An overview of the current literature. CNS Neurosci Ther. 2012;18(9):711–721.
9.
PaolucciSAntonucciGGrassoMGPost-stroke depression, antidepressant treatment and rehabilitation results. A case-control study. Cerebrovasc Dis. 2001;12(3):264–271.
10.
SinyorDAmatoPKaloupekDGBeckerRGoldenbergMCoopersmithH. Post-stroke depression: relationships to functional impairment, coping strategies, and rehabilitation outcome. Stroke. 1986;17(6):1102–1107.
11.
DownhillJEJrRobinsonRG. Longitudinal assessment of depression and cognitive impairment following stroke. J Nerv Ment Dis. 1994;182(8):425–431.
12.
RasquinSLodderJVerheyF. The association between psychiatric and cognitive symptoms after stroke: a prospective study. Cerebrovas Dis. 2005;19(5):309–316.
NysGMvan ZandvoortMJvan der WorpHBEarly depressive symptoms after stroke: neuropsychological correlates and lesion characteristics. J Neurol Sci. 2005;228(1):27–33.
15.
BergAPalomäkiHLehtihalmesMLönnqvistJKasteM. Poststroke depression: an 18-month follow-up. Stroke. 2003;34(1):138–143.
16.
TownendBSWhyteSDesboroughTLongitudinal prevalence and determinants of early mood disorder post-stroke. J Clin Neurosci. 2007;14(5):429–434.
17.
HackettMLAndersonCS. Predictors of depression after stroke: a systematic review of observational studies. Stroke. 2005;36(10):2296–2301.
18.
ColeMGDendukuriN. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry. 2003;160(6):1147–1156.
OuimetMAPrimeauFColeMG. Psychosocial risk factors in poststroke depression: a systematic review. Can J Psychiatry. 2001;46(9):819–828.
21.
JohnsonJLMinarikPANyströmKVBautistaCGormanMJ. Poststroke depression incidence and risk factors: an integrative literature review. J Neurosci Nurs. 2006;38(suppl 4):316–327.
22.
AlbrechtTATaylorAG. Physical activity in patients with advanced-stage cancer: a systematic review of the literature. Clin J Oncol Nurs. 2012;16(3):293–300.
23.
FongDYHoJWHuiBPPhysical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344:e70.
24.
OuelletMCMorinCMLavoieA. Volunteer work and psychological health following traumatic brain injury. J Head Trauma Rehabil. 2009;24(4):262–271.
25.
HuskyMGindreCMazureCMComputerized ambulatory monitoring in mood disorders: feasibility, compliance, and reactivity. Psychiatry Res. 2010;178(2):440–442.
26.
JohnsonEISibonIRenouPRouanetFAllardMSwendsenJ. Feasibility and validity of computerized ambulatory monitoring in stroke patients. Neurology. 2009;73(19):1579–1583.
27.
HamiltonM. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62.
28.
BergALönnqvistJPalomäkiHKasteM. Assessment of depression after stroke: a comparison of different screening instruments. Stroke. 2009;40(2):523–529.
29.
MahoneyFIBarthelDW. Functional evaluation: The Barthel index. Md State Med J. 1965;14(14):61–65.
30.
QzuinnTJLanghornePStottDJ. Barthel index for stroke trials: development, properties, and application. Stroke. 2011;42(4):1146–1151.
31.
BrottTAdamsHPJrOlingerCPMeasurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864–870.
32.
AdamsHPJrDavisPHLeiraECBaseline NIH Stroke Scale score strongly predicts outcome after stroke: A report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology. 1999;53(1):126–131.
33.
Brandstätter H. Well-being and motivational person - environment fit: A time - sampling study of emotions. Eur J Pers. 2006;8(2):75-93.
34.
SwendsenJDNormanS. Preparing for community violence: mood and behavioral correlates of the second Rodney King verdicts. J Trauma Stress. 1998;11(1):57–70.
35.
PattenSBWilliamsJVLavoratoDHBullochAG. Reciprocal effects of social support in major depression epidemiology. Clin Pract Epidemiol Ment Health. 2010;6:126–131.
36.
HorganOMacLachlanM. Psychosocial adjustment to lower-limb amputation: a review. Disabil Rehabil. 2004;26(14-15):837–850.
37.
LiuDGWangSSPengRJInteraction of social support and psychological stress on anxiety anddepressive symptoms in breast cancer patients. Asian Pac J Cancer Prev. 2011;12(10):2523–2529.
38.
HayeeMAAkhtarNHaqueARabbaniMG. Depression after stroke-analysis of 297 stroke patients. Bangladesh Med Res Counc Bull. 2001;27(3):96–102.
39.
OuimetMAPrimeauFColeMG. Psychosocial risk factors in poststroke depression: a systematic review. Can J Psychiatry. 2001;46(9):819–828.
40.
AndersenGVestergaardKIngemann-NielsenMLauritzenL. Risk factors for post-stroke depression. Acta Psychiatr Scand. 1995;92(3):193–198.
41.
KouwenhovenSEKirkevoldMEngedalKBiongSKimHS. The lived experience of stroke survivors with early depressive symptoms: A longitudinal perspective. Int J Qual Stud Health Well-being. 2011;6(4).
42.
SibonILassalle-LagadecSRenouPSwendsenJ. Evolution of depression symptoms following stroke: a prospective study using computerized ambulatory monitoring. Cerebrovasc Dis. 2012;33(3):280–285.
43.
BijlRVRavelliAvan ZessenG. Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol. 1998;33(12):587–595.
44.
WittchenHUJacobiF. Size and burden of mental disorders in Europe--a critical review and appraisal of 27 studies. Eur Neuropsychopharmacol. 2005;15(4):357–376.
