Few Screened for Post-Stroke Depression

Depression screenings after a stroke is often infrequent

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Depression is common after a stroke, but a new study suggests that doctors are assessing few stroke patients, potentially offering too much treatment to some patients and too little to others who may need anti-depressants.

More than a quarter of stroke patients are affected by depression. Depressed patients are more likely to have longer hospital stays and make slower rehabilitation progress.

"Be proactive - Tell your doctor if you are depressed."

Katherine Salter, BA, a research associate at Parkwood Hospital in Ontario, noted that a lot of people are being treated for depression, though doctors can't be sure the right ones are being treated. She said the study indicated that 40 percent of participants were treated for depression, though most were not first screened or diagnosed.

During the study researchers examined the medical charts of 294 stroke patients discharged from one of five inpatient rehabilitation programs in Ontario over a six-month period that began in September 2010.

They noted that only three of the patients receiving anti-depressants had been formally screened, assessed and diagnosed though more than 100 patients were receiving treatment for depression.

Investigators also determined that all of the patients who took antidepressants before they began in-patient rehabilitation continued taking medication after discharge without being reassessed.

“No matter what the best practice recommendations say, if you’re on an antidepressant when you show up, you will not likely be screened or assessed, but you will be given more drugs,” Salter said.

Researchers said the findings also suggest patients without a history of depression could be overlooked for treatment. Salter blamed lack of access for patients and the reluctance of clinicians to change the practice.

“Screening for depression after all strokes could result in more positive outcomes for patients and their families,” said Ian Joiner, BScPT, MPA, the director of stroke for Canada's Heart and Stroke Foundation. “With screening, those who would benefit from specialized medication, counseling and referral to other health professionals won’t be missed.”

The research was recently presented at the Canadian Stroke Congress in Calgary.

Reviewed by: 
Review Date: 
October 2, 2012
Last Updated:
October 3, 2012