Usefulness of the Japan Stroke Scale-Depression Scale-(JSS-D) for the diagnosis of post-stroke depression

Abstract

Background: Post-stroke depression (PSD) has a great impact on the quality of life of patients with stroke. The Mini International Neuropsychiatric Interview (MINI) and the Hamilton Depression Scale (HAM-D17) are considered the most reliable diagnostic tests for depression. However, both are difficult to conduct in a clinical setting since they require completion of a questionnaire in a limited time period. The Japan Stroke Scale -Depression Scale- (JSS-D) was established by the Japan Stroke Society to evaluate mood disorders following stroke, including PSD. Here, we correlated the results of HAM-D17, MINI and JSS-D scores. Methods: We studied 100 stroke patients (mean age: 64.6±11.6 [±SD], range: 32-85 years) in the subacute phase (2-5 weeks after onset). We determined the correlations between HAM-D17 and JSS-D scores. We used MINI to diagnose PSD, which represented major and minor depression, and compared the results with those of JSS-D. Results: JSS-D scores correlated with those of HAM-D17 (r=0.847, p <0.0001). The cutoff value of JSS-D score for PSD was 2.40. The sensitivity and specificity were 0.950 and 0.988, respectively. Conclusion: JSS-D is the most valuable diagnostic test for PSD based on its ease of use and reliability for estimating PSD in Japan. © 2008 The Japanese Society of Internal Medicine.