engleski

Depression and suicidality among elderly patients after suffering a stroke

Introduction Depression may occur as a result of vascular disease in a significant subpopulation of elderly persons. In these people, depression mainly affects those with chronic medical illnesses and cognitive impairment, causes suffering, family disruption, and disability, worsens the outcomes of many medical illnesses, and increases mortality. Age-related intertwined with disease-related processes such as artherosclerosis, inflammatory, immune and endocrine changes compromise the integrity of important brain pathways (frontostriatal, amygdala, hypocampus) and increase vulnerability to depression. Recent studies indicate a high frequency of depression in older patients with cardiovascular and cerebrovascular diseases, and the possibility of a bidirectional relationship between depression and vascular disease. The concept of vascular depression is clinicaly challenging therefore also represents a great burden for neurologists and psychiatrists. Often associated with depression is also suicidality and elderly have the highest risk of completed suicide than any other age group worldwide. Since these issues reflect our everyday clinical work we decided to conduct a research involving the post-stroke elderly patients. Materials and methods Our research was conducted od Department of Neurology in Clinical Hosiptal Centre Osijek. We included post-stroke patients (women and men equally) above age 60 and with intact communication skills during their treatment in our Clinic. Each patinet were given scales for assesment of depressive symptomes (Hamilton depression rating scale HAM-D), suicidality (Columbia suicide severity rating scale CSSR-S) and the list for assesment of borderline personality symptomes (Borderline Symptom List BSL) with examination of mental state (MMSE). These scale were given prior to antidepressant treatment and two weeks following the treatment. Results The obtained resultes shown greater incidence of depressive symptomes in post-stroke women and higher incidence of affirmative symptoms for borderline personality structure. In the group of male patients were more often the suicidal ideations with only moderate symptomes of depression. Conclusion In this research we found that both groups were having some form of depressive symptoms with variable manifestation intensity from which resulted suicidal ideations in some patients. These results again confirmed the necessity for interdisciplinary approach to such patients and the need for more vigorous treatment of depression in elderly.

depression; suicidal idea; suicidal behaviour; borderline personality traits; stroke

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