Browsing by Author "Khalili, Sara"

Filter results by typing the first few letters
Now showing 1 - 1 of 1
  • No Thumbnail Available
    Item
    Prevalence of depressive symptoms in patients with idiopathic normal pressure hydrocephalus before and after shunt surgery
    (2020-04-27) Khalili, Sara; University of Gothenburg / Institute of Medicine; Göteborgs universitet / Institutionen för medicin
    Abstract Degree Project, Programme in Medicine, “Prevalence of depressive symptoms in patients with idiopathic normal pressure hydrocephalus before and after shunt surgery” by Sara Khalili, 2019, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden. Background Idiopathic normal pressure hydrocephalus (iNPH) is associated with a symptom triad of gait and balance problems, urinary incontinence and cognitive decline. The characteristic cognitive symptoms such as apathy, mental fatigue, etc. may bear a resemblance to depressive symptoms, leading to either an actual depression imitating iNPH cognitive symptoms or iNPH masking an existing depression. Aim Describe depressive symptoms in iNPH, evaluate the effect of shunt surgery on these symptoms and test the hypothesis that depressive behavior is more related to iNPH symptomatology than negative thoughts. Methods Ninety-two iNPH patients (33 females, 59 males, mean age 74 years) underwent a detailed clinical assessment pre- and three months postoperatively by the iNPH scale. Depressive symptoms were assessed by Beck's depression inventory (BDI). Results Pre-operatively, mean BDI score was 11.8 (SD 7.5) with 96 % of patients exhibiting depressive symptoms (85% minimal or mild; 11% moderate; 4% severe). Post-operatively, 84% of patients improved ≥5 iNPH scale points and mean BDI improved to 8.8 (SD 6.6) (p<0.001). Both depressive behavior and negative thoughts improved but the improvement was most pronounced for behavior (95% CI 1.4-3.5 vs 0.3-1.9) (p<0.001). A postoperative improvement on the iNPH scale correlated with improvement in BDI score (Rp=0.29, p=0.02) and depressive behavior (Rp=0.27, p=0.02) and at a trend level with negative thoughts (Rp=0.22, p=0.06). Conclusion Depressive symptoms seem abundant in iNPH patients, although often in minimal or mild forms. Depressive symptoms in general improve after shunt surgery. This improvement correlates with more pronounced clinical improvement, most evident for depressive behavior, supporting the notion that some depressive symptoms are part of the iNPH state.