Impacto dos sintomas depressivos na percepção global de melhoria em sobreviventes de acidente vascular cerebral

Abstract

Introduction: Stroke is one of the leading causes of mortality and disability worldwide. Psycho-emotional disorders, particularly post-stroke depression, are common and have been associated with poorer functional recovery, increased disability, and reduced quality of life. Objectives: To examine the impact of depressive symptoms and to explore the potential influence of additional factors (sociodemographic, clinical, related with rehabilitation programs, and social support) on subjective perception of improvement and functionality in stroke survivors. Methodology: Cross-sectional, single-center study with consecutive inclusion of stroke survivors between February and June 2025. Eligible participants were aged ≥18 years and assessed within six months post-stroke. Exclusion criteria included aphasia, significant cognitive impairment, or a new cerebrovascular event during the study period. Sociodemographic, clinical, and rehabilitation data were collected through electronic medical records and a telephone interview conducted 3 months after the stroke, applying the Patient Global Impression of Change, Hospital Anxiety and Depression Scale, Social Support Satisfaction Scale and Modified Rankin Scale. Statistical analysis was performed using SPSS version 29.0. Results: A total of 70 participants were included, 61.4% of whom were male. The median age was 71 years (interquartile range=60.0-76.3). At three months post-stroke, 26% of patients exhibited depressive symptoms. Depressive symptomatology was significantly associated with lower perceived improvement (p<0.001) and poorer functional outcomes (p=0.010). Furthermore, younger age (p=0.016), marital status (married; p=0.030), higher education (university; p=0.014), higher frequency of physical activity per week (p=0.007), absence of psychiatric history (p=0.001), lower anxiety levels (p=0.026), absence of insomnia (p=0.003), and participation in outpatient rehabilitation programs (p=0.015) were all significantly associated with higher perceived improvement. In this sample, perceived improvement was significantly correlated with actual functional progression (p<0.001). Conclusion: Perceived recovery is a clinically relevant factor, being significantly associated with functional outcomes at 3 months after stroke. Depressive symptomatology impacts both perceived recovery and post-stroke functional outcomes.