Depresión post-ictus: frecuencia y factores determinantes

Otman Fernández Concepción, Mirna Marrero Fleita, Yoani Mesa Barrero, Norge de Jesús Santiesteban Velázquez, Joan Rojas Fuentes

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OBJETIVOS: Determinar la frecuencia de depresión en supervivientes a un ictus e identificar los factores que explican su presencia.

MÉTODOS: Se estudiaron 120 pacientes, los cuales se clasificaron según la escala geriátrica de depresión en: no deprimido (<5 puntos), con síntomas depresivos (5–9 puntos), y depresión postictus (DPI) (=10 puntos). Para definir los factores asociados a la depresión se incluyeron variables dependientes (demográficas, antecedentes y hábitos tóxicos, sobre la enfermedad y sus consecuencias) y se utilizaron métodos de análisis bivariado y regresión logística (RL).

RESULTADOS: el 76% de los pacientes presentó síntomas depresivos, un tercio de ellos DPI. La afectación del lóbulo frontal (43% vs 19%) y la dependencia (42% vs 14%) se asociaron a la DPI en el análisis bivariado; sin embargo, perdieron su efecto en el análisis multivariado. En el modelo de RL mostró que tener deterioro cognitivo (OR: 2,6; IC95%: 1,02–6,72) y el grado de afectación neurológica (entre grave y moderada OR: 0,20; IC95%: 0,04–0,86, entre grave y leve OR: 0,22; IC95%: 0,07–0,65) son los factores que explicaron de forma independiente la presencia de DPI.

CONCLUSIONES: Un tercio de los pacientes tuvieron DPI. Los factores de mayor fuerza explicativa para presentar DPI fueron la gravedad de la afectación neurológica y la presencia de deterioro cognitivo.

Palabras clave

Depression; Neurological impairments; Post–stroke depression; Risk factors; Stroke

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