Depressive symptoms in caregivers immediately after stroke.
Eeeseung Byun, Lois Evans, Marilyn Sommers and 2 others
PMID 30929619WHAT IT FOUND
Depressive symptoms stayed similar from 2 to 6 weeks, but 57% of caregivers had at least mild symptoms early.
Uncertainty, stress, coping, support, income, and stroke-survivor function were linked to symptoms; cortisol was not.
Key findings
01Depressive symptoms did not change between 2 weeks and 6 weeks poststroke, but 57% of caregivers had at least mild symptoms early and 47% still had symptoms at 6 weeks.
02Caregiver uncertainty, perceived stress, coping, social support, race, income, time spent caregiving, and stroke-survivor race and functional status were associated with more depressive symptoms when tested one at a time; cortisol was not.
03At follow-up, greater depressive symptoms were correlated with elevated evening salivary cortisol, but cortisol was not associated with overall repeated depressive symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study used a convenience sample from two academic centers in one geographic region. It may not apply to other areas. The caregivers were generally well educated and most had health insurance. This may not apply to less advantaged groups. The sample was small: 63 caregivers enrolled and 40 completed follow-up. Some caregivers did not complete the study. Those who dropped out may have had more caregiving responsibilities and depressive symptoms. Non-completers had more social support at baseline and were more likely to be non-Hispanic White. This may bias who was followed. The study tested many characteristics one at a time without adjusting for others. Some associations could be chance findings. The study followed caregivers only to 6 weeks and did not test whether interventions reduce depressive symptoms. The findings are associations. They do not prove that uncertainty, stress, coping, support, income, caregiving time, or stroke-survivor function caused depression.
Declared interests
The supplied article text does not include a funding or conflict-of-interest declaration. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that uncertainty, stress, or stroke-survivor function caused caregiver depression, or that evening cortisol is a useful marker. The study was observational, tested many characteristics one at a time without adjusting for others, and cortisol was not associated with overall depressive symptoms.