| Does prestroke depression impact poststroke depression and treatment? | |
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MedLine Citation:
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PMID: 20220578 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To 1) describe the prevalence of before the stroke depression (BSD) and poststroke depression (PSD) and 2) serotonin selective reuptake inhibitor (SSRI) treatment patterns. DESIGN: Naturalistic, retrospective cohort design. SETTING: Veterans Healthcare System. PARTICIPANTS: Seven hundred ninety veterans with confirmed stroke during fiscal year 2001. MEASUREMENTS: Diagnosis of depression and dispensing for antidepressants before and after stroke. RESULTS: A depression diagnosis was noted for nearly 10% (N = 74) of veterans before their stroke and nearly 26% afterward (N = 205). Among those with a BSD diagnosis, 75.7% received a PSD diagnosis after their stroke. Only 20.9% of the veterans without a BSD diagnosis received a PSD diagnosis afterward (odds ratio [OR] = 9.5, 95% confidence interval [CI] = 5.4-16.5). Nearly 32% were dispensed a SSRI. Veterans receiving an SSRI before their stroke were more likely to receive one afterward (OR = 31.9, 95% CI: 17.4-58.4). Nearly 48% of those with a BSD diagnosis were dispensed an SSRI < or =30 days if they had a PSD diagnosis < or =30 days, but 48% without a PSD diagnosis were still dispensed an SSRI < or =30 days if they had a BSD diagnosis. Conversely, among those without a BSD diagnosis, 39.4% were dispensed an SSRI < or =30 days if they had a PSD diagnosis but only 7.2% without a PSD diagnosis in < or =30 days with no BSD diagnosis. CONCLUSION: Patients' depression status before the stroke is a significant predictor of PSD and providers' SSRI prescribing behavior but not age. Given the deleterious effects of PSD, physicians may be tending toward prophylaxis or early treatment even before the evidence to support such treatment leads to standard practice recommendations. |
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Authors:
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L Douglas Ried; Huanguang Jia; Randi Cameon; Hua Feng; Xinping Wang; Michael Tueth |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry Volume: 18 ISSN: 1545-7214 ISO Abbreviation: Am J Geriatr Psychiatry Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-06-28 Completed Date: 2010-11-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9309609 Medline TA: Am J Geriatr Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 624-33 Citation Subset: IM |
Affiliation:
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Malcom Randall Veterans Affairs Medical Center, Gainsville, FL, USA. Doug.Ried@swosu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cohort Studies Depression / diagnosis, drug therapy, epidemiology* Female Hospitals, Veterans Humans Male Medicare Odds Ratio Physician's Practice Patterns Prevalence Retrospective Studies Serotonin Uptake Inhibitors / administration & dosage, therapeutic use* Stroke / complications, psychology* United States / epidemiology Veterans |
| Chemical | |
Reg. No./Substance:
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0/Serotonin Uptake Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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