Depression, Personality and Stroke

Depression is considered to be the most common psychiatric sequelae of stroke and is known to impede rehabilitation and recovery. If it was possible to identify factors present in the acute phase of stroke, which could identify patients at risk of developing affective disorder in the post-stroke period, then early intervention could be implemented to potentially alleviate the symptoms and improve recovery. The main factors being considered in this study, were the patients' personality characteristics and affective status at the onset of the stroke. Other factors that were considered as potential influences were, age, gender, disability, risk factors, laterality of the CVA and blood measurements recorded in the acute phase of stroke. The personality and affective status of one hundred and twelve patients and thirty-four cohabiting carers were assessed on three occasions within six months from the onset of stroke. Assessments were carried out within 48 hours of stroke and at 6 weeks and 6 months after stroke, and were performed using standard depression and personality questionnaires: viz. the Beck Depression Inventory (BDI), the Eysenck Personality Scales (EPS) and the Faschingbauer Abbreviated Minnesota Multiphasic Personality Inventory (FAM). The results demonstrated that similar levels of affective disorder were present in patients and carers at each of the assessments. The percentage of patients and carers whose affective status remained unchanged over the six months was also similar. The study identified a small number of patients who were not depressed in the acute phase of the stroke, and who became depressed during the 6 months after stroke. The onset of depression was associated with being female generally, and being female with a right CVA. No significant association was found between affective status and disability, age or blood measurements. The outcomes also demonstrated that for patients and carers, depression and certain personality scores, in the acute phase of the stroke, were significant predictors of depression scores at 6 months. There were significant changes in the personality characteristics of patients over the 6 months of the study, which were not replicated in carers. A significant association between the affective status of patients and their carers was also demonstrated, but the association was significant for male patients and female carers only. There was no association between the affective status of female patients and male carers