Depression Characterization and Race Among Stroke Survivors Receiving Inpatient Rehabilitation.
Terrence Pugh, Mark A Hirsch, Vu Q C Nguyen and 9 others
PMID 30211718WHAT IT FOUND
Depression was documented in 35% of white, 22% of African American, and 16.7% of other race/ethnicity stroke inpatient rehabilitation patients.
New onset rates were 21.6%, 14.5%, and 16.7%.
Key findings
01Depression was documented in 35% of white, 22% of African American, and 16.7% of other race/ethnicity stroke inpatient rehabilitation patients, with a significant difference between groups.
02After adjustment, African American patients had lower odds of documented depression than white patients (adjusted OR 0.52, 95% CI 0.41 to 0.68), and other race/ethnicity patients had lower odds (adjusted OR 0.37, 95% CI 0.19 to 0.71).
03Female sex, neglect, cognitive deficits, and no hyperlipidemia were associated with more likely documented depression.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Depression was based on clinical documentation, not a standardized assessment, so some providers may have documented it more or less often. The study was retrospective and could not include variables such as premorbid alcohol use, family involvement, or cultural support. Combining no depression with not documented may undercount depression. The chart abstracted sample was 1570, but 1501 were eligible for analysis. Findings come from three southeastern US inpatient rehabilitation facilities between 2009 and 2011, so they may not apply to current care or other regions.
Declared interests
The paper is tagged as supported by NIH extramural and non-U.S. government research funding.
The easy way to misread this
Do not read the lower adjusted odds for African American and other race/ethnicity patients as evidence that these patients have less true depression. The outcome was depression documented in clinical records, not a standardized diagnosis, and provider documentation may differ by race or clinical awareness.