Self-rated health, symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke: a municipality-based study in Sweden

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Abstract

Background

Self-rated health is an important indicator of quality of life as well as a good predictor of future health. The purpose of the study was to follow up the self-rated health and the prevalence of symptoms of depression and general symptoms in a population of first-ever stroke patients 3 and 12 months after stroke.

Methods

All patients surviving their first-ever stroke and residing in Nacka municipality in Stockholm County Council were included using a multiple overlapping search strategy during an 18-month period ( n = 187). Our study group comprised the 145 patients who survived the first 3 months after stroke. Three and 12 months after their stroke, the patients were assessed regarding self-rated health and general symptoms using parts of the Göteborg Quality of Life Instrument (GQLI), and regarding symptoms of depression using the Montgomery Asberg Depression Scale (MADRS-S).

Results

Self-rated health was rated as very good or rather good by 62% at 3 months after stroke and by 78% at 12 months after stroke. More than half of the patients suffered from symptoms of depression, with no significant improvement at 12 months. The most common general symptoms at 3 months after stroke were fatigue, sadness, pain in the legs, dizziness and irritability. Fatigue and sadness were still common at 12 months. Twelve months after stroke the prevalences of crying easily, irritability, impaired concentration, nausea and loss of weight were significantly lower.

Conclusion

The majority of patients rated their health as rather good or very good at 3 and 12 months after stroke. However, the majority suffered from fatigue and from symptoms of depression after both 3 and 12 months. In continued care of stroke survivors, it is important to consider the fact that many patients who rate their health as good may nevertheless have symptoms of depression, and some of them may benefit from anti-depressive treatment.

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Most cited references 33

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Self-rated health and mortality: a review of twenty-seven community studies.

E. L. Idler, Y Benyamini (1997)

We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.

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Frequency of depression after stroke: a systematic review of observational studies.

Maree Hackett, Chaturangi M Yapa, Varsha Parag … (2005)

Although depression is an important sequelae of stroke, there is uncertainty regarding its frequency and outcome. We undertook a systematic review of all published nonexperimental studies (to June 2004) with prospective consecutive patient recruitment and quantification of depressive symptoms/illness after stroke. Data were available from 51 studies (reported in 96 publications) conducted between 1977 and 2002. Although frequencies varied considerably across studies, the pooled estimate was 33% (95% confidence interval, 29% to 36%) of all stroke survivors experiencing depression. Differences in case mix and method of mood assessment could explain some of the variation in estimates across studies. The data also suggest that depression resolves spontaneously within several months of onset in the majority of stroke survivors, with few receiving any specific antidepressant therapy or active management. Depression is common among stroke patients, with the risks of occurrence being similar for the early, medium, and late stages of stroke recovery. There is a pressing need for further research to improve clinical practice in this area of stroke care.

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Quality of life after stroke.

Bradley R. King (1996)

The purposes of this study were to examine overall and domain-specific quality of life in long-term stroke survivors and to identify variables that predict quality of life after stroke. The study used a cross-sectional, descriptive correlational design. Subjects were 86 stroke survivors who were interviewed 1 to 3 years after stroke. Quality of life was measured with the use of an instrument that assesses satisfaction and importance for four domains (health and functioning, socioeconomic, family, and psychological-spiritual). Independent variables were age, social class, aphasia, functional status, motor impairment, depression, comorbidity, and perceived social support. Multiple regression analysis was used to predict quality of life. Thirty percent of subjects scored in the depressed range. The mean overall quality of life score was relatively high and was comparable to that of a normative population. Quality of life was highest for the family domain and lowest for health and functioning. Depression, perceived social support, and functional status predicted quality of life (adjusted R2 = .38) and contributed to prediction of domain quality of life. Social support and three additional variables, social class, age, and cardiovascular disease, predicted socioeconomic quality of life. The identification of depression, social support, and functional status as predictors of quality of life suggests the need to assist stroke survivors in coping and in maintaining and strengthening their support systems.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Fam Pract

Title: BMC Family Practice

Publisher: BioMed Central

ISSN (Electronic): 1471-2296

Publication date Collection: 2007

Publication date (Electronic): 17 October 2007

Volume: 8

Page: 61

Affiliations

[1 ]CeFAM (Centre for Family and Community Medicine), Karolinska Institute, Alfred Nobels väg 12, SE-141 83 Huddinge, Sweden

Article

Publisher ID: 1471-2296-8-61

DOI: 10.1186/1471-2296-8-61

PMC ID: 2174472

PubMed ID: 17941995

SO-VID: fedf379e-101d-408b-98c1-a048d9129d90

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Self-rated health, symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke: a municipality-based study in Sweden

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Abstract

Background

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Conclusion

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Stroke MRI

Most cited references 33

Self-rated health and mortality: a review of twenty-seven community studies.

Frequency of depression after stroke: a systematic review of observational studies.

Quality of life after stroke.

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