Marie Villain

Risk and protective factors for Post-Stroke Depression: a daily life approach.

Defended on October 19 2016

Abstract :

Post-stroke depression (PSD) is one of the most common psychiatric complications following stroke with detrimental consequences in terms of functional recovery and quality of life. Its identification and treatment at the earliest stages of care remains a clinical challenge. The aim of this thesis is to study risk and protective factors for PSD based on data collected in the contexts of daily life. In the first section, we present a study of the role played by social support and routinization on the severity of depressive symptoms three months after stroke by Ecological Momentary Assessment (EMA). In the second section, we examine the voice as an early marker of PSD. We observed that patient perceptions of better support quality, and not quantity, immediately following mild stroke, are associated with better behavioral and emotional outcomes three months later. In addition, we observed a unidirectional pattern of association between mood and routines, whereby the occurrence of routines was associated with a higher level of depressive symptomatology over subsequent hours.

Finally, voice analysis allowed us to identify PSD markers with longitudinal changes in fundamental voice frequency and discriminant analysis demonstrated that initial voice breaks coupled with shimmer are strongly predictive of subsequent PSD. Beyond commonly-recognized clinical risk factors such as stroke severity, these ecological investigations identified new markers for PSD whose detection could lead to new strategies for prevention and care. Mots-clés : AVC, Dépression, Méthode d’échantillonnage des expériences, Soutien social, Prosodie, Routines. Keywords : Stroke, Depression, Ecological Momentary Assessment, Social support, Routines, Prosody.


 Jury

  • Stacey CALLAHAN
  • Peggy GATIGNOL
  • Pascale PRADAT-DIEHL
  • Igor SIBON
  • Joël SWENDSEN

PhD supervisor

Joël Swendsen, Ph.D.
Director of Research
National Center for Scientific Research
University of Bordeaux, EPHE
33076 Bordeaux, France

Last update: 4 April 2018