Depression and routinization following stroke

Objective. Post-stroke depression is a frequent complication of stroke with detrimental consequences for quality of life and functional outcomes. In response to these difficulties, individuals may increasingly use behavioral routines but little information is available concerning its role in emotional disturbance following stroke. The aim of this investigation is to assess the association of behavioral routines with negative affect at baseline and three months later using Ecological Momentary Assessment. Methods. Forty-four patients with minor ischemic stroke were consecutively enrolled in the study. Stroke severity, handicap, and severity of depression and anxiety symptoms were assessed at baseline hospitalization. The Ecological Momentary Assessment phase was conducted three months after hospital discharge and involved repeated electronic interviews concerning daily life behaviors, mood and depression symptoms. Routines were operationalized as the repetition of specific activities occurring at the same time period across days. Results. Higher baseline depression and anxiety symptom severity were significantly associated with increased routines three-months after stroke. Concerning the dynamic association of mood symptoms with routines, the occurrence of routines was associated with a higher level of subsequent depressive symptomatology. Conclusion. The findings demonstrate a unidirectional pattern of association between mood and routines in this vulnerable population.