Having not seen an
apathy scale, I wonder if they used tiredness as a marker for depression which would bias all survivors towards a depression diagnosis.
http://www.ncbi.nlm.nih.gov/pubmed/23930743
Source
Department
of Psychiatry, Carver College of Medicine, University of Iowa, IA;
Department of Psychiatry, Tokai University School of Medicine, Kanagawa,
Japan.
Abstract
OBJECTIVE:
Apathy
occurs frequently following stroke and prior studies have demonstrated
the negative effect of apathy on recovery from stroke. This study was a
secondary analysis examining the efficacy of escitalopram,
problem-solving therapy (PST), or placebo administered for 1 year to
prevent the onset of apathy among patients with recent stroke.
METHODS:
Patients
within 3 months of an index stroke who did not meet DSM-IV diagnostic
criteria for major or minor depression and who did not have a serious
comorbid physical illness were enrolled. Patients were recruited from
three sites: University of Iowa, University of Chicago, and Burke
Rehabilitation Hospital. One hundred fifty-four patients without
evidence of apathy at initial evaluation were included in the randomized
controlled trial using escitalopram (10 mg patients ≤65 years; 5 mg
patients >65 years) (N = 51) or placebo (N = 47) or non-blinded PST
(12 total sessions) (N = 56) over 1 year. At 3, 6, 9, and 12 months,
patients were assessed for diagnosis and severity of apathy using the
Apathy Scale.
RESULTS:
Using a Cox proportional hazards
model of time to onset of apathy, participants given placebo were 3.47
times more likely to develop apathy than patients given escitalopram and
1.84 times more likely to develop apathy than patients given PST after
controlling for age, sex, cognitive impairment, and diabetes mellitus
status (adjusted hazard ratio: 3.47, 95% CI: 1.79-6.73 [escitalopram
group]; adjusted hazard ratio: 1.84, 95% CI: 1.21-2.80 [PST group]).
CONCLUSION:
Escitalopram or PST was significantly more effective in preventing new onset of apathy following stroke compared with placebo.
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