中老年人中風後憂鬱症之危險因子相關分析

Risk Factors of Post-Stroke Depression in Middle-Aged Adults and the Elderly

程遠揚(Yuan-Yang Cheng) ； 周正亮(Chen-Liang Chou) ； 鄭舜平(Shun-Ping Cheng) ； 劉作仁(Tcho-Jen Liu) ； 詹瑞棋(Rai-Chi Chan) ； 翁文章(Wen-Jang Wong)

《台灣復健醫學雜誌》 33卷3期 (2005/09) Pp. 149-159

https://doi.org/10.6315/2005.33(3)04

摘要

為研究國人中風後發生憂鬱症的盛行率以及其相關危險因子，本研究蒐集來自台北市某醫學中心神經內科就診或在復健部進行復健的一百零二位中風病患，以病歷回溯的方式取得病患的客觀資料如年齡，中風區域，中風發生到問卷統計進行的時間，中風發生次數，有無服用抗憂鬱劑，以及目前進行的復健治療，再以問卷調查的方式評估病患的吞嚥功能，憂鬱程度，以及功能性獨立指標(Functional Independence Measure)。統計結果，中風後憂鬱症的盛行率為33.3%，其中64.7%服用抗憂鬱劑。另外，相關性統計結果顯示憂鬱指數與功能性獨立指標呈負相關(r=0.262, p=0.008)，亦與大部分功能性獨立指標的子項分數呈負相關，其中相關係數最高者為自我照顧能力(r=0.277, p=0.005)。在本研究中，我們並未發現中風後病患的憂鬱程度與病患的年齡、中風區域、距中風發生時間問、中風次數或是吞嚥功能有統計上的相關意義存在。經由本研究發現，與憂鬱指數相關性最高的因子為病患的自我照顧能力，因此在臨床實用上，可提供醫師一個快速預估病患憂鬱症傾向的指標，以作為投藥治療或是預防中風後憂鬱症的參考。

關鍵字

中風 ； 憂鬱症 ； 危險因子

並列摘要

In order to evaluate the prevalence and risk factors of post-stroke depression, this study collected the data of 102 stroke patients from the outpatient clinic of the neurology and rehabilitation departments in a medical center in Taipei. The patients' objective data, such as age, infarction area of the brain, duration from the stroke attack to the time of our study, number of stroke attacks, antidepressant use, and rehabilitation program, were obtained from the history chart. A questionnaire evaluation of the swallowing function, depression status, and functional independence measure was also done by interviewing the patients individually. The results showed that the prevalence of depression was 33.3% in our study, and that 64.7% of that number were under antidepressant treatment. The fact that post-stroke depression is under-diagnosed should be of note. A significantly negative correlation between the depression score and the functional independence measure was obtained from our analysis, and the depression score was also negatively correlated to most of the sub-scales of the functional independence measure. Among the sub-scales, the score for self-care was the item most correlated to the depression score. Difficulties were encountered while evaluating the depression status in stroke patients since some symptoms of stroke may resemble the diagnostic criteria of major depression clinically, and some stroke patients may develop aphasia or cognitive disturbance. Therefore, being the most correlated score to the depression status, the self-care subscale of the functional independence measure may provide an easy and rapid way to evaluate the depression status in those who are difficult to evaluate clinically, and it can also be a useful reference for clinical doctors when prescribing antidepressants for post-stroke patients.

並列關鍵字

stroke ； depression ； risk factor