DeprAS-OWL

Post-stroke depression (PSD) affects one in three people after a stroke and has a negative impact on rehabilitation and quality of life. Of those affected, up to 75% receive no treatment for their depressive symptoms. In order to improve early detection, prevention and the development of suitable treatment methods, it is necessary to understand the development and conditioning factors of PSD.

Studies have repeatedly analysed predictors of PSD. The following variables have been consistently confirmed: 1) the presence of previous depression, 2) everyday impairments (in activities of daily living) and 3) social support. However, these factors often ignore the subjective experience of those affected. After a stroke, many staff, people report the loss of their old "self", which is described in the literature as self-discrepancy. In addition, a stroke also affects relatives, who are an important source of support for those affected and at the same time reach their own limits. It is unclear how gender-dependent aspects of relationships affect the mental health of those affected.
In addition to risk factors that make the occurrence of depression more likely, protective factors should also be taken into account. Resilience and post-traumatic growth are often discussed in the context of physical illnesses. Resilience describes psychological resilience, while post-traumatic growth refers to the phenomenon of staff, people emerging stronger from a crisis such as a stroke.

Therefore, in addition to the PSD predictors known from the literature, DeprAS-OWL also measures 1) self-discrepancy 2) the quality of the relationship with a primary caregiver as well as 3) resilience and 4) post-traumatic growth. In cooperation with the Department of Neurology and Neurogeriatrics, Klinikum Lippe (University Medical Center OWL), staff, people are recruited after a stroke in the stroke unit and subsequently interviewed by telephone over 2 years (3, 6, 12, 18 and 24 months after the stroke). The additional, independent predictive power of the four variables for depression and quality of life will be analysed over these periods. In addition, the influence of relationship quality will be analysed as a function of the gender of stroke patients and their relatives. In addition, the Post-Stroke Depression Risk Scale (PoStDeRiS) developed in a preliminary study will be validated for the early detection of PSD.

 

Literature:

Ladwig, S. & Werheid, K (under review). Self-concept, self-discrepancy and depressive symptoms three years after stroke: A cross-sectional evaluation of predictive value, the role of subdomains, and individual importance.

Wang, Y., Xie, H., Sun, H., Ren, L., Jiang, H., Chen, M., & Dong, C. (2024). Influencing factors of psychological resilience in stroke patients: A systematic review and meta-analysis. Archives of Clinical Neuropsychology.Advance online publication. https://doi.org/10.1093/arclin/acad107

Ladwig, S., Ziegler, M., Südmeyer, M. & Werheid, K. (2022). The Post-Stroke Depression Risk Scale (PoStDeRiS): Development of an acute-phase prediction model for depression 6 months after stroke. Journal of the Academy of Consultation-Liaison Psychiatry, 63(2), 144-152. https://doi.org/10.1016/j.jaclp.2021.08.003