The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach
Background Somatic and neurocognitive symptoms of depression may overlap with the physical symptoms of stroke, and thus make the diagnosis of post‐stroke depression difficult. Aim To assess the sensitivity of individual depressive symptoms and their contribution to the diagnosis of post‐stroke depre...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2005-04, Vol.20 (4), p.358-362 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Coster, Liesbeth de Leentjens, Albert F. G. Lodder, Jan Verhey, Frans R. J. |
| description | Background
Somatic and neurocognitive symptoms of depression may overlap with the physical symptoms of stroke, and thus make the diagnosis of post‐stroke depression difficult.
Aim
To assess the sensitivity of individual depressive symptoms and their contribution to the diagnosis of post‐stroke depression.
Patients and methods
Two hundred and six patients with first‐ever stroke, participating in a longitudinal study, were administered the Structured Clinical Interview for DSM‐IV and the Hamilton Depression Rating Scale (HAM‐D). In a discriminant analysis the relative contribution of the individual HAM‐D items to the diagnosis of major depressive disorder was evaluated.
Results
The cumulative incidence of post‐stroke major depressive disorder was 32%. The discriminant model based on HAM‐D item scores was highly significant (p |
| doi_str_mv | 10.1002/gps.1290 |
| format | Article |
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Somatic and neurocognitive symptoms of depression may overlap with the physical symptoms of stroke, and thus make the diagnosis of post‐stroke depression difficult.
Aim
To assess the sensitivity of individual depressive symptoms and their contribution to the diagnosis of post‐stroke depression.
Patients and methods
Two hundred and six patients with first‐ever stroke, participating in a longitudinal study, were administered the Structured Clinical Interview for DSM‐IV and the Hamilton Depression Rating Scale (HAM‐D). In a discriminant analysis the relative contribution of the individual HAM‐D items to the diagnosis of major depressive disorder was evaluated.
Results
The cumulative incidence of post‐stroke major depressive disorder was 32%. The discriminant model based on HAM‐D item scores was highly significant (p<0.001) and classified 88.3% of patients correctly as depressed or nondepressed. As expected, ‘depressed mood’ discriminated best between depressed and non‐depressed stroke patients. ‘Reduced interests’ had a relatively low sensitivity and may in part reflect ‘apathy’, which often is considered a separate construct. With the exception of ‘suicidal thoughts’, most psychological symptoms, such as ‘hypochondriasis’, ‘lack of insight’ and ‘feelings of guilt’, were not very sensitive. Some somatic symptoms, such as ‘reduced appetite’, ‘psychomotor retardation’, and ‘fatigue’ had high discriminative properties.
Conclusion
Psychological, neurocognitive and somatic symptoms of depression differ among themselves in terms of diagnostic sensitivity, and should be considered individually. Some somatic symptoms are highly sensitive for depression and should not be neglected by following an ‘exclusive’ or ‘attributional’ approach to the diagnosis of PSD. Copyright © 2005 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.1290</identifier><identifier>PMID: 15799083</identifier><identifier>CODEN: IJGPES</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Cognition Disorders - psychology ; depression ; Depressive Disorder - diagnosis ; Discriminant Analysis ; Fatigue - psychology ; Feeding and Eating Disorders - psychology ; Female ; Geriatric psychiatry ; Humans ; Longitudinal Studies ; Male ; Mental depression ; phenomenology ; post-stroke depression ; Prospective Studies ; Psychiatric Status Rating Scales - standards ; Psychomotor Disorders - psychology ; sensitivity ; Sensitivity and Specificity ; specificity ; Stroke ; Stroke - psychology</subject><ispartof>International journal of geriatric psychiatry, 2005-04, Vol.20 (4), p.358-362</ispartof><rights>Copyright © 2005 John Wiley & Sons, Ltd.</rights><rights>Copyright 2005 John Wiley & Sons, Ltd.</rights><rights>Copyright John Wiley and Sons, Limited Apr 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4810-741197b055ee68d3bc9a2bee619f726b4e24fae22fa9a816448a5a13a508cd0f3</citedby><cites>FETCH-LOGICAL-c4810-741197b055ee68d3bc9a2bee619f726b4e24fae22fa9a816448a5a13a508cd0f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.1290$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.1290$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15799083$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coster, Liesbeth de</creatorcontrib><creatorcontrib>Leentjens, Albert F. G.</creatorcontrib><creatorcontrib>Lodder, Jan</creatorcontrib><creatorcontrib>Verhey, Frans R. J.</creatorcontrib><title>The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach</title><title>International journal of geriatric psychiatry</title><addtitle>Int. J. Geriat. Psychiatry</addtitle><description>Background
Somatic and neurocognitive symptoms of depression may overlap with the physical symptoms of stroke, and thus make the diagnosis of post‐stroke depression difficult.
Aim
To assess the sensitivity of individual depressive symptoms and their contribution to the diagnosis of post‐stroke depression.
Patients and methods
Two hundred and six patients with first‐ever stroke, participating in a longitudinal study, were administered the Structured Clinical Interview for DSM‐IV and the Hamilton Depression Rating Scale (HAM‐D). In a discriminant analysis the relative contribution of the individual HAM‐D items to the diagnosis of major depressive disorder was evaluated.
Results
The cumulative incidence of post‐stroke major depressive disorder was 32%. The discriminant model based on HAM‐D item scores was highly significant (p<0.001) and classified 88.3% of patients correctly as depressed or nondepressed. As expected, ‘depressed mood’ discriminated best between depressed and non‐depressed stroke patients. ‘Reduced interests’ had a relatively low sensitivity and may in part reflect ‘apathy’, which often is considered a separate construct. With the exception of ‘suicidal thoughts’, most psychological symptoms, such as ‘hypochondriasis’, ‘lack of insight’ and ‘feelings of guilt’, were not very sensitive. Some somatic symptoms, such as ‘reduced appetite’, ‘psychomotor retardation’, and ‘fatigue’ had high discriminative properties.
Conclusion
Psychological, neurocognitive and somatic symptoms of depression differ among themselves in terms of diagnostic sensitivity, and should be considered individually. Some somatic symptoms are highly sensitive for depression and should not be neglected by following an ‘exclusive’ or ‘attributional’ approach to the diagnosis of PSD. Copyright © 2005 John Wiley & Sons, Ltd.</description><subject>Aged</subject><subject>Cognition Disorders - psychology</subject><subject>depression</subject><subject>Depressive Disorder - diagnosis</subject><subject>Discriminant Analysis</subject><subject>Fatigue - psychology</subject><subject>Feeding and Eating Disorders - psychology</subject><subject>Female</subject><subject>Geriatric psychiatry</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Mental depression</subject><subject>phenomenology</subject><subject>post-stroke depression</subject><subject>Prospective Studies</subject><subject>Psychiatric Status Rating Scales - standards</subject><subject>Psychomotor Disorders - psychology</subject><subject>sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>specificity</subject><subject>Stroke</subject><subject>Stroke - psychology</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0VFr1TAUB_AgDnc3BT-BBB9kL50nadMkvo3LdhUuU3HqY0jb1GVrm5rTq_bbm8stDgTxKYH8cpJz_oQ8Z3DOAPjrbyOeM67hEVkx0DpjrCwfkxUoJbKS53BMThDvANIZU0_IMRNSa1D5ipibW0fRDegn_8NPMw0txdDbydcU536cQo_UD3QMOGU4xXDvaOPG6BB9GN5QSxuPdfS9H-wwUTvYbt7fteMYg61vn5Kj1nboni3rKfl8dXmzfptt32_erS-2WV0oBpksGNOyAiGcK1WTV7W2vEp7plvJy6pwvGit47y12ipWFoWywrLcClB1A21-Sl4d6qZnv-8cTqZP_3JdZwcXdmhKKUFqpf4LeZodlKJI8OVf8C7sYuovGQ6CScF4QmcHVMeAGF1rxjQLG2fDwOyjMSkas48m0RdLvV3Vu-YBLlkkkB3AT9-5-Z-FzObDp6Xg4j1O7tcfb-N96jaXwny93hhV5F8-yvXWXOe_ARTop1o</recordid><startdate>200504</startdate><enddate>200504</enddate><creator>Coster, Liesbeth de</creator><creator>Leentjens, Albert F. G.</creator><creator>Lodder, Jan</creator><creator>Verhey, Frans R. J.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200504</creationdate><title>The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach</title><author>Coster, Liesbeth de ; Leentjens, Albert F. G. ; Lodder, Jan ; Verhey, Frans R. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4810-741197b055ee68d3bc9a2bee619f726b4e24fae22fa9a816448a5a13a508cd0f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Cognition Disorders - psychology</topic><topic>depression</topic><topic>Depressive Disorder - diagnosis</topic><topic>Discriminant Analysis</topic><topic>Fatigue - psychology</topic><topic>Feeding and Eating Disorders - psychology</topic><topic>Female</topic><topic>Geriatric psychiatry</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Mental depression</topic><topic>phenomenology</topic><topic>post-stroke depression</topic><topic>Prospective Studies</topic><topic>Psychiatric Status Rating Scales - standards</topic><topic>Psychomotor Disorders - psychology</topic><topic>sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>specificity</topic><topic>Stroke</topic><topic>Stroke - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coster, Liesbeth de</creatorcontrib><creatorcontrib>Leentjens, Albert F. G.</creatorcontrib><creatorcontrib>Lodder, Jan</creatorcontrib><creatorcontrib>Verhey, Frans R. J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coster, Liesbeth de</au><au>Leentjens, Albert F. G.</au><au>Lodder, Jan</au><au>Verhey, Frans R. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int. J. Geriat. Psychiatry</addtitle><date>2005-04</date><risdate>2005</risdate><volume>20</volume><issue>4</issue><spage>358</spage><epage>362</epage><pages>358-362</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><coden>IJGPES</coden><abstract>Background
Somatic and neurocognitive symptoms of depression may overlap with the physical symptoms of stroke, and thus make the diagnosis of post‐stroke depression difficult.
Aim
To assess the sensitivity of individual depressive symptoms and their contribution to the diagnosis of post‐stroke depression.
Patients and methods
Two hundred and six patients with first‐ever stroke, participating in a longitudinal study, were administered the Structured Clinical Interview for DSM‐IV and the Hamilton Depression Rating Scale (HAM‐D). In a discriminant analysis the relative contribution of the individual HAM‐D items to the diagnosis of major depressive disorder was evaluated.
Results
The cumulative incidence of post‐stroke major depressive disorder was 32%. The discriminant model based on HAM‐D item scores was highly significant (p<0.001) and classified 88.3% of patients correctly as depressed or nondepressed. As expected, ‘depressed mood’ discriminated best between depressed and non‐depressed stroke patients. ‘Reduced interests’ had a relatively low sensitivity and may in part reflect ‘apathy’, which often is considered a separate construct. With the exception of ‘suicidal thoughts’, most psychological symptoms, such as ‘hypochondriasis’, ‘lack of insight’ and ‘feelings of guilt’, were not very sensitive. Some somatic symptoms, such as ‘reduced appetite’, ‘psychomotor retardation’, and ‘fatigue’ had high discriminative properties.
Conclusion
Psychological, neurocognitive and somatic symptoms of depression differ among themselves in terms of diagnostic sensitivity, and should be considered individually. Some somatic symptoms are highly sensitive for depression and should not be neglected by following an ‘exclusive’ or ‘attributional’ approach to the diagnosis of PSD. Copyright © 2005 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>15799083</pmid><doi>10.1002/gps.1290</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Cognition Disorders - psychology depression Depressive Disorder - diagnosis Discriminant Analysis Fatigue - psychology Feeding and Eating Disorders - psychology Female Geriatric psychiatry Humans Longitudinal Studies Male Mental depression phenomenology post-stroke depression Prospective Studies Psychiatric Status Rating Scales - standards Psychomotor Disorders - psychology sensitivity Sensitivity and Specificity specificity Stroke Stroke - psychology |
| title | The sensitivity of somatic symptoms in post-stroke depression: a discriminant analytic approach |
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