Are depressive symptoms nonspecific in patients with acute stroke?
OBJECTIVE: Some investigators have suggested that major depression might be overdiagnosed in stroke patients because of changes in appetite, sleep, or sexual interest caused by their medical illness; others have suggested that depression may be underdiagnosed in stroke patients who deny symptoms of...
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| Veröffentlicht in: | The American journal of psychiatry 1991-09, Vol.148 (9), p.1172-1176 |
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| container_title | The American journal of psychiatry |
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| creator | FEDOROFF, J. P STARKSTEIN, S. E PARIKH, R. M PRICE, T. R ROBINSON, R. G |
| description | OBJECTIVE: Some investigators have suggested that major depression might
be overdiagnosed in stroke patients because of changes in appetite, sleep,
or sexual interest caused by their medical illness; others have suggested
that depression may be underdiagnosed in stroke patients who deny symptoms
of depression because of anosognosia, neglect, or aprosody. The authors'
goal was to determine how frequently depressive symptoms occur in acute
stroke patients with and without depressed mood to estimate how often
diagnostic errors of inclusion or exclusion may be made. METHOD: They
examined the rate of autonomic and psychological symptoms of depression in
205 patients who were consecutively hospitalized for acute stroke.
Eighty-five (41%) of these patients had depressed mood, and 120 (59%) had
no mood disturbance. Forty-six (54%) of the 85 patients with depressed mood
(22% of all patients) were assigned the DSM-III diagnosis of major
depression. RESULTS: The 120 patients without mood disturbance had a mean
of one autonomic symptom, but the 85 patients with depressed mood had a
mean of almost four. Tightening the diagnostic criteria to account for one
more nonspecific autonomic symptom decreased the number of patients with
major depression by only three; adding two more criteria decreased the
number by only five. Thus, the rate of DSM-III major depression was 1%
higher than the rate with one extra nonspecific autonomic symptom and 2%
higher than the rate with two extra criteria. Conversely, loosening
diagnostic criteria to account for denial of depressive illness increased
the rate of major depression by only 5%. CONCLUSIONS: Both autonomic and
psychological depressive symptoms are strongly associated with depressed
mood in acute stroke patients. |
| doi_str_mv | 10.1176/ajp.148.9.1172 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72070934</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1777265</sourcerecordid><originalsourceid>FETCH-LOGICAL-a410t-4a5a85c48b019bab8ff9e732fba21f6e10d777a3d78df278bac57de940ca8e083</originalsourceid><addsrcrecordid>eNp1kM9LHDEUx0Op2FV77U0YVHqRWfNjZpOcRKVVQehFobfwJvNCs-7MxGRG8b9vll1qKfYUvrzP--bxIeQLo3PG5OIMlmHOKjXX68g_kBmrRV1KztVHMqOU8lLX4ucnspfSMkcqJN8lu0wprnU1I5cXEYsWQ8SU_DMW6bUL49Cloh_6FNB6523h-yLA6LEfU_Hix18F2GnM7BiHRzw_IDsOVgk_b9998vD92_3VTXn34_r26uKuhIrRsaygBlXbSjWU6QYa5ZxGKbhrgDO3QEZbKSWIVqrWcakasLVsUVfUgkKqxD75uukNcXiaMI2m88niagU9DlMyklNJtagyePQPuBym2OfbDOe0UlookaHj_0FMMLrI5pTM1HxD2TikFNGZEH0H8dUwatb-TfZvsn-j15HnhcNt7dR02L7hG-F5frKdQ7KwchF669MfrM6VWtUZO91gEIL_67L3P_0N_1WapQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1310600287</pqid></control><display><type>article</type><title>Are depressive symptoms nonspecific in patients with acute stroke?</title><source>MEDLINE</source><source>Psychiatry Legacy Collection Online Journals 1844-1996</source><source>Periodicals Index Online</source><creator>FEDOROFF, J. P ; STARKSTEIN, S. E ; PARIKH, R. M ; PRICE, T. R ; ROBINSON, R. G</creator><creatorcontrib>FEDOROFF, J. P ; STARKSTEIN, S. E ; PARIKH, R. M ; PRICE, T. R ; ROBINSON, R. G</creatorcontrib><description>OBJECTIVE: Some investigators have suggested that major depression might
be overdiagnosed in stroke patients because of changes in appetite, sleep,
or sexual interest caused by their medical illness; others have suggested
that depression may be underdiagnosed in stroke patients who deny symptoms
of depression because of anosognosia, neglect, or aprosody. The authors'
goal was to determine how frequently depressive symptoms occur in acute
stroke patients with and without depressed mood to estimate how often
diagnostic errors of inclusion or exclusion may be made. METHOD: They
examined the rate of autonomic and psychological symptoms of depression in
205 patients who were consecutively hospitalized for acute stroke.
Eighty-five (41%) of these patients had depressed mood, and 120 (59%) had
no mood disturbance. Forty-six (54%) of the 85 patients with depressed mood
(22% of all patients) were assigned the DSM-III diagnosis of major
depression. RESULTS: The 120 patients without mood disturbance had a mean
of one autonomic symptom, but the 85 patients with depressed mood had a
mean of almost four. Tightening the diagnostic criteria to account for one
more nonspecific autonomic symptom decreased the number of patients with
major depression by only three; adding two more criteria decreased the
number by only five. Thus, the rate of DSM-III major depression was 1%
higher than the rate with one extra nonspecific autonomic symptom and 2%
higher than the rate with two extra criteria. Conversely, loosening
diagnostic criteria to account for denial of depressive illness increased
the rate of major depression by only 5%. CONCLUSIONS: Both autonomic and
psychological depressive symptoms are strongly associated with depressed
mood in acute stroke patients.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/ajp.148.9.1172</identifier><identifier>PMID: 1882994</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Washington, DC: American Psychiatric Publishing</publisher><subject>Acute Disease ; Autonomic Nervous System Diseases - complications ; Autonomic Nervous System Diseases - diagnosis ; Autonomic Nervous System Diseases - psychology ; Biological and medical sciences ; Brain - diagnostic imaging ; Cerebrovascular Disorders - complications ; Cerebrovascular Disorders - diagnostic imaging ; Cerebrovascular Disorders - psychology ; Depressive Disorder - complications ; Depressive Disorder - diagnosis ; Depressive Disorder - psychology ; Female ; Hospitalization ; Humans ; Male ; Medical sciences ; Mental depression ; Middle Aged ; Neurology ; Psychiatric Status Rating Scales ; Psychiatry ; Social research ; Stroke ; Tomography, X-Ray Computed ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>The American journal of psychiatry, 1991-09, Vol.148 (9), p.1172-1176</ispartof><rights>1992 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Sep 1991</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a410t-4a5a85c48b019bab8ff9e732fba21f6e10d777a3d78df278bac57de940ca8e083</citedby><cites>FETCH-LOGICAL-a410t-4a5a85c48b019bab8ff9e732fba21f6e10d777a3d78df278bac57de940ca8e083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ajp.148.9.1172$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ajp.148.9.1172$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,776,780,2846,21608,27846,27901,27902,77760,77761</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5176985$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1882994$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FEDOROFF, J. P</creatorcontrib><creatorcontrib>STARKSTEIN, S. E</creatorcontrib><creatorcontrib>PARIKH, R. M</creatorcontrib><creatorcontrib>PRICE, T. R</creatorcontrib><creatorcontrib>ROBINSON, R. G</creatorcontrib><title>Are depressive symptoms nonspecific in patients with acute stroke?</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>OBJECTIVE: Some investigators have suggested that major depression might
be overdiagnosed in stroke patients because of changes in appetite, sleep,
or sexual interest caused by their medical illness; others have suggested
that depression may be underdiagnosed in stroke patients who deny symptoms
of depression because of anosognosia, neglect, or aprosody. The authors'
goal was to determine how frequently depressive symptoms occur in acute
stroke patients with and without depressed mood to estimate how often
diagnostic errors of inclusion or exclusion may be made. METHOD: They
examined the rate of autonomic and psychological symptoms of depression in
205 patients who were consecutively hospitalized for acute stroke.
Eighty-five (41%) of these patients had depressed mood, and 120 (59%) had
no mood disturbance. Forty-six (54%) of the 85 patients with depressed mood
(22% of all patients) were assigned the DSM-III diagnosis of major
depression. RESULTS: The 120 patients without mood disturbance had a mean
of one autonomic symptom, but the 85 patients with depressed mood had a
mean of almost four. Tightening the diagnostic criteria to account for one
more nonspecific autonomic symptom decreased the number of patients with
major depression by only three; adding two more criteria decreased the
number by only five. Thus, the rate of DSM-III major depression was 1%
higher than the rate with one extra nonspecific autonomic symptom and 2%
higher than the rate with two extra criteria. Conversely, loosening
diagnostic criteria to account for denial of depressive illness increased
the rate of major depression by only 5%. CONCLUSIONS: Both autonomic and
psychological depressive symptoms are strongly associated with depressed
mood in acute stroke patients.</description><subject>Acute Disease</subject><subject>Autonomic Nervous System Diseases - complications</subject><subject>Autonomic Nervous System Diseases - diagnosis</subject><subject>Autonomic Nervous System Diseases - psychology</subject><subject>Biological and medical sciences</subject><subject>Brain - diagnostic imaging</subject><subject>Cerebrovascular Disorders - complications</subject><subject>Cerebrovascular Disorders - diagnostic imaging</subject><subject>Cerebrovascular Disorders - psychology</subject><subject>Depressive Disorder - complications</subject><subject>Depressive Disorder - diagnosis</subject><subject>Depressive Disorder - psychology</subject><subject>Female</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychiatry</subject><subject>Social research</subject><subject>Stroke</subject><subject>Tomography, X-Ray Computed</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>K30</sourceid><recordid>eNp1kM9LHDEUx0Op2FV77U0YVHqRWfNjZpOcRKVVQehFobfwJvNCs-7MxGRG8b9vll1qKfYUvrzP--bxIeQLo3PG5OIMlmHOKjXX68g_kBmrRV1KztVHMqOU8lLX4ucnspfSMkcqJN8lu0wprnU1I5cXEYsWQ8SU_DMW6bUL49Cloh_6FNB6523h-yLA6LEfU_Hix18F2GnM7BiHRzw_IDsOVgk_b9998vD92_3VTXn34_r26uKuhIrRsaygBlXbSjWU6QYa5ZxGKbhrgDO3QEZbKSWIVqrWcakasLVsUVfUgkKqxD75uukNcXiaMI2m88niagU9DlMyklNJtagyePQPuBym2OfbDOe0UlookaHj_0FMMLrI5pTM1HxD2TikFNGZEH0H8dUwatb-TfZvsn-j15HnhcNt7dR02L7hG-F5frKdQ7KwchF669MfrM6VWtUZO91gEIL_67L3P_0N_1WapQ</recordid><startdate>19910901</startdate><enddate>19910901</enddate><creator>FEDOROFF, J. 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G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a410t-4a5a85c48b019bab8ff9e732fba21f6e10d777a3d78df278bac57de940ca8e083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Acute Disease</topic><topic>Autonomic Nervous System Diseases - complications</topic><topic>Autonomic Nervous System Diseases - diagnosis</topic><topic>Autonomic Nervous System Diseases - psychology</topic><topic>Biological and medical sciences</topic><topic>Brain - diagnostic imaging</topic><topic>Cerebrovascular Disorders - complications</topic><topic>Cerebrovascular Disorders - diagnostic imaging</topic><topic>Cerebrovascular Disorders - psychology</topic><topic>Depressive Disorder - complications</topic><topic>Depressive Disorder - diagnosis</topic><topic>Depressive Disorder - psychology</topic><topic>Female</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychiatry</topic><topic>Social research</topic><topic>Stroke</topic><topic>Tomography, X-Ray Computed</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FEDOROFF, J. P</creatorcontrib><creatorcontrib>STARKSTEIN, S. E</creatorcontrib><creatorcontrib>PARIKH, R. M</creatorcontrib><creatorcontrib>PRICE, T. R</creatorcontrib><creatorcontrib>ROBINSON, R. 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P</au><au>STARKSTEIN, S. E</au><au>PARIKH, R. M</au><au>PRICE, T. R</au><au>ROBINSON, R. G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are depressive symptoms nonspecific in patients with acute stroke?</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>1991-09-01</date><risdate>1991</risdate><volume>148</volume><issue>9</issue><spage>1172</spage><epage>1176</epage><pages>1172-1176</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>OBJECTIVE: Some investigators have suggested that major depression might
be overdiagnosed in stroke patients because of changes in appetite, sleep,
or sexual interest caused by their medical illness; others have suggested
that depression may be underdiagnosed in stroke patients who deny symptoms
of depression because of anosognosia, neglect, or aprosody. The authors'
goal was to determine how frequently depressive symptoms occur in acute
stroke patients with and without depressed mood to estimate how often
diagnostic errors of inclusion or exclusion may be made. METHOD: They
examined the rate of autonomic and psychological symptoms of depression in
205 patients who were consecutively hospitalized for acute stroke.
Eighty-five (41%) of these patients had depressed mood, and 120 (59%) had
no mood disturbance. Forty-six (54%) of the 85 patients with depressed mood
(22% of all patients) were assigned the DSM-III diagnosis of major
depression. RESULTS: The 120 patients without mood disturbance had a mean
of one autonomic symptom, but the 85 patients with depressed mood had a
mean of almost four. Tightening the diagnostic criteria to account for one
more nonspecific autonomic symptom decreased the number of patients with
major depression by only three; adding two more criteria decreased the
number by only five. Thus, the rate of DSM-III major depression was 1%
higher than the rate with one extra nonspecific autonomic symptom and 2%
higher than the rate with two extra criteria. Conversely, loosening
diagnostic criteria to account for denial of depressive illness increased
the rate of major depression by only 5%. CONCLUSIONS: Both autonomic and
psychological depressive symptoms are strongly associated with depressed
mood in acute stroke patients.</abstract><cop>Washington, DC</cop><pub>American Psychiatric Publishing</pub><pmid>1882994</pmid><doi>10.1176/ajp.148.9.1172</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-953X |
| ispartof | The American journal of psychiatry, 1991-09, Vol.148 (9), p.1172-1176 |
| issn | 0002-953X 1535-7228 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72070934 |
| source | MEDLINE; Psychiatry Legacy Collection Online Journals 1844-1996; Periodicals Index Online |
| subjects | Acute Disease Autonomic Nervous System Diseases - complications Autonomic Nervous System Diseases - diagnosis Autonomic Nervous System Diseases - psychology Biological and medical sciences Brain - diagnostic imaging Cerebrovascular Disorders - complications Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - psychology Depressive Disorder - complications Depressive Disorder - diagnosis Depressive Disorder - psychology Female Hospitalization Humans Male Medical sciences Mental depression Middle Aged Neurology Psychiatric Status Rating Scales Psychiatry Social research Stroke Tomography, X-Ray Computed Vascular diseases and vascular malformations of the nervous system |
| title | Are depressive symptoms nonspecific in patients with acute stroke? |
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