PREVENTION OF POSTNATAL DEPRESSION IN CONDITIONS OF THE STROKE CENTER
About the author:
Muratova T. M., Khramtsov D. M., Vorokhta Yu. M., Vikarenko M. S.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The purpose of the study was to evaluate the effectiveness of prevention of postnatal depression (PID) in patients with acute cerebrovascular accident. Object and methods. The study was performed at the stroke unit of the neurological department of the University Clinic of the Odessa National Medical University during 2016-2018. Under supervision, there were 217 patients with acute ischemic stroke. The examination and treatment were carried out in accordance with the requirements of the order N 602 d. 03.082012 “On approval and implementation of medical-technological documents on the standardization of medical care for ischemic stroke”. Additionally, the severity of depressive manifestations was evaluated using the HADS-D scale in patients with preserved speech function (n = 159). Clinical results with the use of various antidepressants were analysed. The term of follow-up observation was 6 months. Statistical processing was performed using the software Statistica 10.0 (Dell StatSoft Inc., USA). Results. Males (52.0%) prevailed in the study sample. The average age was 60.4±1.1 years, the average NIHSS score was 10.1±0.09. 149 (68.7%) patients were admitted to the clinic during the first day after the first clinical manifestations of stroke. The average length of stay in the hospital was 10.2±0.9 days. Manifestations of postnatal depression were identified in 53 (33.3%) patients whose average age was 54.2±1.5 years. 67.9% of patients received various SIRS in the standard doses and other patients received vortioxetine in a dosage of 10-20 mg per day. At the time of the initial survey, the score on the HADS-D scale was an average of 8.8±0.1 points. Six months after discharge, patients continued receiving drugs, those receiving SIRS average score on the HADS-D scale was 7.7±0.1 points, and in patients taking vortioxetin – 6.2±0.1 scores. Conclusion. It was shown that the incidence of post-stroke depression in patients with ischemic stroke exceeds 30%. In assessing the role of various risk factors among the examined patients with PID, the prevalence of male patients (OR = 1.3 (1.1-1.5)), under the age of 55 (1.7 (1.3-1.9)), with the history of depression episodes in the past (1.6 (1.4-1.8)), as well as alcohol abuse (1.2 (1.0-1.3)). In 31 (58.5%) cases focal ischemia was localised in the frontal lobe of the dominant hemisphere. The use of both SIRS and an antidepressant with multimodal effect – vortioxetine was sufficiently effective in postnatal depression whereas vortioxetin showing the best results. The paper considers the expediency of the use of vortioxetin for preventing PID in patients with ischemic stroke.
postnatal depression, ischemic stroke, diagnosis, treatment.
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 156-160 pages, index UDK 10.21518/2079-701Х-2017-0-47-51