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Facteurs de risque et de protection pour la dépression post AVC : approche en vie quotidienne

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
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Submitted on : Wednesday, April 17, 2019 - 11:05:09 AM
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  • HAL Id : tel-02102299, version 1




Marie Villain. Facteurs de risque et de protection pour la dépression post AVC : approche en vie quotidienne. Neurosciences [q-bio.NC]. École pratique des hautes études - EPHE PARIS, 2016. Français. ⟨NNT : 2016EPHE3058⟩. ⟨tel-02102299⟩



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