Early Depression Screening is Feasible in Hospitalized Stroke Patients (S62.005)

OBJECTIVE: We assessed the hypothesis that early depression screening in stroke patients is feasible and explored factors associated with early post-stroke depression. BACKGROUND: Depression after stroke is common but is not routinely assessed in hospitalized patients. As a Comprehensive Stroke Center, we screen all stroke inpatients for depression, though the feasibility and utility of early screening have not been established. DESIGN/METHODS: The records of all patients admitted with ischemic stroke (IS) or intracerebral hemorrhage (ICH) between 2/1/13 and 4/15/13 were reviewed. A depression screen, modified from the Patient Health Questionnaire-9 (PHQ-9), was administered (maximum score 27, higher scores indicating worse depression). Patients were eligible if they did not have a medical condition precluding screening (e.g. comfort care, aphasia). RESULTS: Of 303 IS and ICH inpatients, 158 (52.15%) were screened. Nearly three-quarters of all eligible patients were screened (76.87% IS and 66.17% ICH). Eligible patients were most often not screened due to being missed (screen not ordered or ordered and not performed). Median scores (IQR) on the modified PHQ-9 for IS and ICH patients were 3 (1-6) and 3 (0-5), respectively. More than one-third of all IS and ICH patients (35.44%) screened positive for depression (score > 4). Females (OR 0.43, 95% CI 0.22-0.85) and younger patients (0.98, 95% CI 0.95-0.99) were more likely to screen positive. Screening positive was not associated with poor discharge/day 7 outcome (mRS > 3; OR 1.45, 95% CI 0.74-2.83). CONCLUSIONS: Screening stroke inpatients for depression is feasible and early depression after stroke is common, although it is possible that depression preceded stroke in some of our patients. Younger patients and women are more likely to experience early depression after stroke. Our results provide preliminary evidence supporting the continued use of early depression screening after stroke, though additional studies on quality of life and long-term outcome are necessary to further assess the utility of early post-stroke depression screening. Disclosure: Dr. Karamchandani has nothing to disclose. Dr. Vahidy has nothing to disclose. Dr. Bajgur has nothing to disclose. Dr. Vu has nothing to disclose. Dr. Choi has nothing to disclose. Dr. Oladunjoye has nothing to disclose. Dr. Hamilton has nothing to disclose. Dr. Savitz has received personal compensation for activities with Celgene, Aldagen, KM Pharmaceutical, and GlaxoSmithKline Inc. Dr. Savitz received research support from Johnson & Johnson, Athersys, Celgene, Genentech Inc., and Aldagen.