Psychopathological evaluation and use of the Hospital Anxiety and Depression Scale in a sample of Brazilian patients with post-stroke depression

ABSTRACT

Abstract Background: Depression is the most frequent psychiatric complication of stroke and is often undetected or inadequately treated. Objective: This study aimed to characterize psychopathological aspects of Brazilian patients admitted to an acute stroke unit, and to evaluate the performance of the Hospital Anxiety and Depression Scale (HADS) in detecting cases of depression. Methods: This was a cross-sectional study. Sixty consecutive patients admitted to an acute stroke unit were assessed with the National Institutes of Health Stroke Scale, the Modified Rankin Scale, the Functional Independence Measure, the Mini International Neuropsychiatric Interview-Plus, the HADS, the Mini Mental State Examination (MMSE) and the Pathological Laughing and Crying Scale. Results: Prevalence of depression was 26.7%. Patients with post-stroke depression were more likely to present diabetes (p < 0.01) and had greater disability (p < 0.001) and cognitive impairment (p < 0.001) in comparison to non-depressed patients. Depressed patients showed worse performance specifically on tasks of attention/calculation and language of the MMSE. ROC curve analysis of HADS provided a cutoff value of 6 for detecting depression (sensitivity 83.3%; specificity 83.3%). The depression subscale of HADS (HADS-D) presented sensitivity of 100% and specificity of 99.17%. Discussion: HADS-D showed good performance in screening for depressive symptoms after acute stroke.