Impact of depression following a stroke on the participation component of the International Classification of Functioning, Disability and Health

Abstract

Purpose: To assess the impact of post-stroke depression on the participation component of the International Classification of Functioning, Disability and Health (ICF).

Method: Thirty-five stroke survivors with chronic hemiparesis were divided into two groups: those with and without depression. The Geriatric Depression Scale (GDS) was used for the analysis of depressive symptoms. Participation was analysed using the Stroke Specific Quality of Life scale. The Mann–Whitney test was used to compare the participation scores between the two groups. Spearman’s correlation coefficients were calculated to determine the strength of the association between the assessment tools. Simple linear regression was used to determine the impact of depression on participation. An alpha risk of 0.05 was considered indicative of statistical significance.

Results: The group with depression had low participation scores (p = 0.04). A statistically significant negative correlation of moderate magnitude was found between depression and participation (r =  −0.6; p  = 0.04). The linear regression model demonstrated that depression is a moderate predictor of participation (r² = 0.51; p = 0.001).

Conclusions: Depression is a moderate predictor of participation among stroke survivors, explaining 51% of the decline of this aspect. Thus, depression should be diagnosed, monitored and treated to ensure a better prognosis regarding social participation following a stroke.

Implications for Rehabilitation

• Individuals with post-stroke depression experience a lower degree of social participation.

• Depression explains 51% of the decline in participation following a stroke.

• The present findings can serve as a basis to assist healthcare professionals involved in the rehabilitation of stroke survivors and can assist in the establishment of adequate treatment plans in stroke rehabilitation.

Keywords:

• Depression
• disability and health
• International Classification of Functioning
• quality of life
• social participation
• stroke

Declaration of interest

This study received funding from the Brazilian fostering agency State of São Paulo Research Assistance Foundation (FAPESP; process number: 2013/10877-7).