| dc.description.abstract | Introduction
Major depression is a pervasive disorder that influences many different populations. According to the National Institute of Mental Health (NIH) and data from the National Survey on Drug Use and Health from 2020, 8.4% of adults have experienced at least one major depressive episode (U.S. Department of Health and Human Services, 2022).
Depression has been studied in individuals who have had a stroke to examine its prevalence and impact on health outcomes. Researchers have found that the incidence of depression amongst stroke survivors was 14.1% (de Man-van Ginkel et al., 2015). In general, depression has been shown to increase mortality risk (Gilman et al., 2017). For stroke survivors, depression has the added impact of influencing rehabilitation outcomes and medical care costs. More specifically, it has been shown to have a negative effect on functional outcomes, continuation of social activities, and quality of life (Ahn et al., 2015).
Many individuals with communication disorders report higher levels of depression. Individuals with aphasia lie at the cross-section of stroke and communication disorders. However, the diagnosis of depression may be missed due to the communication difficulties people with aphasia face. Most measures of depression rely heavily on strong communication skills and have not been normed for populations with communication difficulties. The demands on the language system may influence an individual with aphasia’s ability to accurately respond to the items on the assessment.
Currently, the research on how to accurately assess depression in people with post-stroke aphasia is limited. Depression can have a significant impact on these individuals (e.g., poorer rehabilitation outcomes, increased mortality, decreased quality of life) (Laures-Gore et al., 2020), so it is important to have a thorough understanding of how to diagnose depression in this population. The purpose of this systematic review is to develop a better understanding of how depression is measured in this population and how the communication needs of people with aphasia are being met during assessments.
Methods
For this systematic review, the PubMed and PsycInfo databases were searched, using the keywords “Aphasia[Title/Abstract]” AND “Depression [Title/Abstract] OR Mood Disorder [Title/Abstract] OR AdjustmentDisorder [Title/Abstract] OR Emotion [Title/Abstract] OR Affect [Title/Abstract] OR Affective Disorders[Title/Abstract]” AND “Communication OR Speech OR Language”.
The papers included in the final analysis were empirical, peer-reviewed articles (inclusive of case studies). Master’s and doctoral theses that did not go through the peer review process, review papers, book chapters, commentaries, etc. were excluded. Papers were also excluded if they addressed mania or bipolar disorder or were not in English. Papers were included if a) depression symptoms were measured (e.g., depression assessment/screener, patient/caregiver measure), b) at least some participants were diagnosed with aphasia due to stroke, and c) data from participants with aphasia is distinct from the data from those without aphasia.
Interrater reliability will be assessed at each level of screening and evaluation. At each level, 30% of the papers will be screened by another researcher. At the data collection level, reliability will be based on 3 binary variables: the presence of aphasia assessment, depression assessment, and modifications. For any discrepancies during the reliability check, a consensus meeting will take place and a third rater will come in as needed.
Anticipated Results
From this review, I expect to find that researchers are using a wide range of assessments to assess depression in individuals with aphasia post-stroke. I believe usage will be based on feasibility, length, resources, and more. Additionally, I do not believe there will be many depression assessments created specifically for individuals with aphasia nor many that include individuals with aphasia in their standardized sample. Instead, I expect to see general depression measures that may have been changed to accommodate people with aphasia but that these accommodations have not been researched in this context. | en_US |
