Patient Health Questionnaire-9 predicts the functional outcome of stroke patients in convalescent rehabilitation ward

Masahiro Nakamori, Eiji Imamura, Keisuke Tachiyama, Teppei Kamimura, Yuki Hayashi, Hayato Matsushima, Hiroyuki Okamoto, Tatsuya Mizoue, Shinichi Wakabayashi, Masahiro Nakamori, Eiji Imamura, Keisuke Tachiyama, Teppei Kamimura, Yuki Hayashi, Hayato Matsushima, Hiroyuki Okamoto, Tatsuya Mizoue, Shinichi Wakabayashi

Abstract

Introduction: Poststroke depression (PSD) negatively affects the functional outcome of stroke patients. Patient Health Questionnaire-9 (PHQ-9) is a validated screening tool for detecting PSD. This study investigated the relationship between PHQ-9 score and functional outcomes in stroke patients in a convalescent rehabilitation ward by evaluating functional independence measure (FIM) gain scores and the proportion of patients discharged.

Methods: In this retrospective study conducted from January 2017 to September 2019, consecutive stroke patients who were admitted to the convalescent rehabilitation ward and could answer PHQ-9 were assessed. The association between PHQ-9 scores at the time of admission to the convalescent rehabilitation ward and outcomes (FIM gain score and the proportion of patients discharged) was statistically analyzed.

Results: Among the 215 patients enrolled in the study, 62 (28.8%) were assessed as having depression, in whom PHQ-9 scores were 5 or above. Multivariate analysis revealed that the PHQ-9 score on admission to the convalescent rehabilitation ward was a significant independent factor influencing the FIM gain score (p = .009). In addition, a multivariate analysis revealed that the PHQ-9 score at the time of admission to the convalescent rehabilitation ward was a significant independent factor influencing the inability to discharge a patient (odds ratio 1.24, 95% confidence interval 1.12-1.39, p < .001).

Conclusions: The PHQ-9 score is a useful tool for predicting patient functional outcome, admission to the facility, and screening for poststroke depression.

Keywords: activities of daily living; depression; patient health questionnaire; stroke rehabilitation.

Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

© 2020 The Authors. Brain and Behavior published by Wiley Periodicals LLC.

Figures

FIGURE 1
FIGURE 1
Transitive graphs of PHQ‐9 per month. (a)–(d) shows the transitive PHQ‐9 scores for hospital‐stay periods of 1, 2, 3, and 4 months, respectively. PHQ‐9, Patient Health Questionnaire‐9

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