Caractéristiques et suivi de la dépression post-accident vasculaire cérébral à Kinshasa

BACKGROUND The World Health Organization has identified the emergence of non -communicable chronic diseases in developing countries including strokes. In Africa, stroke ranks first among the causes of death. Depression (PSD) is a common complication after stroke onset. To our knowledge there are no systematic studies which have focused on PSD Democratic Republic of Congo. OBJECTIVE The overall objective is to promote holistic care of stroke patients. To achieve this goal the following specific objectives were defined: to assess the prevalence of PSD, to determine the sociodemographic factors associated with the PSD occurrence , to determine clinical factors associated with PSD contribute to a better understanding of the term clinical PSD, to describe the evolution of the clinical profile of DPAVC on a one-year period , to determine factors associated to the development PSD over a period of one year. PATIENTS AND METHODS Two cross-sectional studies 58 and 56 patients and a longitudinal study of 30 patients were conducted between 1 August 2011 and 31 August 2012 at the rehabilitation center for people with disabilities in Kinshasa. The results have been published or accepted for publication by journals as articles. This doctoral dissertation was based on these three items. RESULTS Men were more represented than women. The subjects were rather young. Three quarters between them were under 65. The PSD was frequent among patients (53.6 %). The level of education of the patients was quite high. The PSD was associated with age ≥ 65 years, low level of education, the severity of neurological impairment assessed with the National Institutes of Health Stroke Scale (NIHSS), apathy by the scale of the apathy of Lille (LARS), evaluated with the scale of severity of fatigue (FSS) fatigue, the degree of disability assessed with the modified Rankin Scale (mRS) and poor condition assessment health by the patient. On the other side, satisfied subjects by perceived social support were less depressed than unmet subjects. Over a period of one year, the prevalence of depression did not differ significantly. Factors such as apathy and age ≥ 65 years remained associated with PSD with an increase in strength of the association for the first. CONCLUSION The PSD is common in Kinshasa. The observed frequence is, similar to that observed in previous work in the world and in Africa. Frequency remains stable over time. The results will allow a better understanding of the disease and improve care by involving psychiatrists in collaboration with the family or the immediate environment of the patient.