Original Article Elmer Press J Clin Med Res • 2010;2(1):39-43 Depression and Recovery of Daily Life Autonomy in Patients With Stroke Receiving Home Rehabilitative Treatment Maria Concetta Cataldoa, c, Alfonso Accursioa, Maria Luisa Calcaraa, Giuseppe Caputoa, Francesca Dal Maschioa, Pasquale D’Antonia, Giuseppe Limaa, Silvia Pirrottaa, Giovanna Rizzoa, Antonino Russob, Vincenzo Salernoa, Caterina Mamminab Abstract Background: The object of this study was to evaluate the preva- lence of post stroke depression and its possible role as a predictive negative factor in patients receiving home rehabilitation treatment. Methods: We analyzed 103 patients with stroke by correlating co- morbidities, clinical and blood test parameters and characteristics of the lesion with depression class identified according to the Ham- ilton scale and the outcome of the rehabilitation program. Results: A significant association between hypertension and post- stroke severe depression emerged in the female patients. Conclusions: Since the literature offers conflicting data, our re- sults may contribute a stimulus for further studies. Keywords: Home care; Rehabilitation; Stroke; Depression; Hy- pertension Introduction Stroke is the first cause of disability in Western countries and depression is the most frequent psychiatric disorder in patients with stroke. According to a recent systematic review of the literature post-stroke depression may affect up to 33% of these patients, with very wide fluctuations depending on whether the studies were based on hospital cases or popula- tion cases.7 Many studies show that between 30 and 50% of Manuscript accepted for publication December 21, 2009 aGeriatric Assessment Unit of Integrated Home care Health District 10, ASP6, Palermo, Italy, bDepartment of Sciences for Health Promotion “G. D’Alessandro”, University of Palermo, Italy cCorresponding author: m.c.cataldo@alice.it doi:10.4021/jocmr2009.02.250w patients develop post-stroke depression in the early stages following the acute event and this seems to increase risk of mortality in the short, medium and long term [1, 2]. Since subjects who have suffered an acute cerebral vas- cular event are very often multi-problem patients, depressive attitudes are often underestimated. In these cases, diagno- sis of depression may be very challenging because patients’ complaints frequently refer to non specific somatic symp- toms which are common in many chronic diseases affect- ing the elderly [3]. Indeed, according to recent reports, it is highly probable that unexplained somatic symptoms at a first clinical assessment, are actually parts of a depressive frame- work [4, 5]. Even though the impact of post-stroke depres- sion on the functional outcome of these patients has gener- ated some interest, literature on its influence on the attentive functions and, consequently, on post-rehabilitation recovery, is limited. It is known that the natural history of stroke is pos- itively influenced by rehabilitation which should be started as soon as possible. The quality of recovery is also deter- mined by the type of cognitive processes that are being acti- vated. Rehabilitation techniques are based on the assumption that the subjects may recover their lost or impaired ability or learn to reorganize their motor behaviour in relation to the residual functions surviving to the injury. Everything is then influenced by the ability or willingness to learn and save what is being learned [6, 7]. Therefore, it is obvious that the identifying factors affecting the patient’s recovery may fa- cilitate the prognosis quod valetudinem and the achievement of rehabilitation target. The aim of our study was to measure whether and in what measure depression negatively affected the process of recovery of patients with stroke receiving home care. More- over, given the frequent presence of post-stroke depression and its negative influence on the outcome of the rehabili- tative treatment, we investigated possible associations be- tween risk factors present in the acute phase of the illness and the onset of depression after the stroke. Patients and Methods One hundred and three patients were recruited in the study at Articles © The authors, Journal compilation © J Clin Med Res and Elmer Press™, www.jocmr.org 39