[Participation after stroke: the influence of depression in outpatient neurological rehabilitation]

J Marheineke, R Deck, P Reuther, D Pöppl, F Theves, T Kohlmann
Der Nervenarzt 2018 September 20

BACKGROUND: Depressiveness is a known and common problem after stroke, which puts a great burden on those affected. The main goal for stroke rehabilitation is to achieve the maximum possible self-determination and participation in the community. This research study examined how depressive symptoms influence the course of participation in outpatient neurological rehabilitation.

METHODS: Stroke rehabilitants from 17 German outpatient neurological rehabilitation centers were interviewed in a multicentric observational study. Within the current work, data on participation and depressive symptoms recorded at the beginning and at the end of rehabilitation by self-assessment questionnaires, were evaluated.

RESULTS: Data of 342 rehabilitants were considered. Results of a multinomial logistic regression analysis indicated that the depression value at the end of rehabilitation, in particular, proved to be a good predictor for the improvement in participation. The lower the depressiveness, the more likely an improvement in participation. At the beginning of the rehabilitation program there were no significant differences between mean depression scores of patients who improved and patients who deteriorated.

DISCUSSION: A relationship between depressiveness and participation was shown. The treatment of depressive symptoms through timely administered psychotherapeutic and medicinal care and general activity promotion could influence the participation in a beneficial way.

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