umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Psychosocial function and life satisfaction after stroke
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
1992 (English)In: Stroke, Vol. 23, no 4, 527-531 p.Article in journal (Refereed) Published
Abstract [en]

This prospective study was designed to describe different aspects of psychosocial function after stroke and the development of changes over time. A major aim has been to identify mental, functional, and social factors associated with low life satisfaction late after stroke.

Social network, functional ability, leisure-time activities, experience of ill health, major depression, and life satisfaction were assessed repeatedly over 3 years in a population-based sample of 50 long-term survivors of stroke (mean age 71.4 years).

Compared with a general elderly population, patients 3 years poststroke had more psychiatric symptoms, lower functional ability, and reduced life satisfaction. Contacts with children were maintained over the 3-year follow-up period, whereas contacts with friends and neighbors declined early after stroke and remained lower than in the general elderly population (p less than 0.05). When time dependency was analyzed, activities of daily living and somatic/neurological symptoms were found to change little after 3 months, while psychiatric symptoms showed changes later. Between 3 and 12 months poststroke, the prevalence of major depression decreased, leisure-time activities and social contacts were partly resumed, and life satisfaction improved (p less than 0.01). Once good life satisfaction was restored it was maintained, and poor life satisfaction at 1 year remained poor for the entire 3 years.

It is concluded that major depression early after stroke, functional disability, and an impaired social network interact to reduce life satisfaction for the long-term survivors of stroke.

Place, publisher, year, edition, pages
American Heart Association , 1992. Vol. 23, no 4, 527-531 p.
Keyword [en]
Stroke
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-99077DOI: 10.1161/01.STR.23.4.527OAI: oai:DiVA.org:umu-99077DiVA: diva2:785662
Projects
digitalisering@umu
Available from: 2015-02-03 Created: 2015-02-03 Last updated: 2015-04-10Bibliographically approved
In thesis
1. Depression after stroke
Open this publication in new window or tab >>Depression after stroke
1993 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Both stroke and depression are major health problems in the elderly. In this study, the prevalence of major depression after stroke was investigated in a well-defined sample of acute stroke patients (n=80), followed up at 3 months, 1 year, 2 and 3 years after the stroke event. Links to biological and psychosocial factors were examined. Hypercortisolism was studied by the dexamethasone suppression test and compared with healthy elderly. Living conditions (including demographic caracteristics, economic resources, health, functional ability, activity/leisure, social network) and life satisfaction were described before and after stroke in relation to a general elderly population.

Demographic caracteristics, economic resources, social network and psychiatric morbidity prestroke did not differ from the general elderly population. Already prior to the stroke, patients reported more health problems and lower functional ability in many aspects of daily life, more passive leisure time and a lower global life satisfaction. After stroke, contacts with children were maintained, whilst contacts outside the family declined and remained lower than in the general elderly population. Stroke involved a marked reduction in global life satisfaction. Poor life satisfaction at 1 year remained poor for the entire three years; these stroke victims had a higher frequency of major depression early after stroke.

The prevalence of major depression was 25% at the acute stage, 31% at 3 months, decreased to 16% at 1 year, was 19% at 2 years and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in self-care ability and loss of social contacts outside the family were the most important predictors at 3 months. From 1 year onwards, loss of social contacts contributed most to depression and at 3 years also cerebral atrophy. Sixty percent of patients with early depression (0-3 months) had recovered at 1 year; those not recovered at 1 year had a high risk of chronicitation.

Hypercortisolism as measured by the dexamethasone suppression test was associated with major depression late (3 years) but not early (0-3 months) after stroke. At 3 years, the dexamethasone suppression test had a sensitivity of 70%, a specificity of 97%, a positive predictive value of 88%, a negative predicitive value of 91%, and a diagnostic accuracy of 90%. Nonsuppression of dexamethasone at 3 months was a significant predictor of major depression at 3 years.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 1993. 63 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 364
Keyword
Cerebrovascular disorders, stroke, depression, living conditions, life satisfaction, social network, dysphasia, self-care ability, cerebral atrophy, dexamethasone
National Category
Medical and Health Sciences Psychiatry
Identifiers
urn:nbn:se:umu:diva-96912 (URN)91-7174-768-0 (ISBN)
Public defence
1993-04-23, Aulan, Administrationsbyggnaden, BV, Norrlands Universitetssjukhus, Umeå universitet, Umeå, 10:00
Supervisors
Projects
digitalisering@umu
Note

Härtill 5 uppsatser

Available from: 2015-02-03 Created: 2014-12-05 Last updated: 2015-04-10Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Åström, MonicaAsplund, KjellÅström, T.
By organisation
PsychiatryMedicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 426 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf