Depression Common Among Stroke Survivors

Depression prevalent after stroke or transient ischemic attack

(RxWiki News) Feeling a sense of disinterest or hopelessness after a stroke? It may be depression. Stroke or mini stroke survivors are more likely to become depressed as compared to the general population.

Patients who suffer from chronic depression following a stroke were most likely to have a higher degree of disability, be unable to work three months later, and be younger.

Depression rates were similar even among stroke or transient ischemic attack, or mini-stroke, survivors with only mild disability.

"Make a psychiatrist appointment if you notice symptoms of depression."

Dr. Nada El Husseini, an author of the study and a Stroke Fellow in the division of neurology at Duke University Medical Center, said the similar rates of depression following a stroke or mini-stroke could stem from similarities in the rates of other medical conditions, or direct effects of brain injury on the risk of depression, though she said more studies would be needed to nail down the cause.

Investigators analyzed 1,450 adults with ischemic stroke and 397 with mini stroke through the AVAIL (Adherence eValuation After Ischemic Stroke Longitudinal) Study, which included 106 hospitals across the U.S. They also analyzed patients in hospitals participating in the American Heart Association’s Get With The Guidelines Stroke from 2006 through 2008.

Among stroke patients, the median age was 64, while transient ischemic attack patients were a median age of 68. About 44 percent of stroke patients and 54 percent of mini stroke patients were women, and most were Caucasian.

Clinicians used the Patient Health Questionnaire-8, which covers a range of depressive symptoms, to diagnose depression in patients.

Researchers found that three months after hospitalization, 17.9 percent of stroke patients and 14.4 percent of mini stroke patients were suffering from depression, a significant increase over the general population. Those numbers had declined slightly at 12 months, with 16.4 percent of stroke survivors and 12.8 percent of mini stroke survivors suffering from depression.

At both the three month and 12 month marks, about 70 percent of depressed patients had not received treatment with anti-depressants.

“Patients need to be open about their symptoms of depression and discuss them with their physicians so that they can work together to improve outcomes. It is important for physicians to screen for depression on follow-up after both stroke and TIA," said Dr. El Husseini.

“Physicians may need to be more vigilant in screening these patients because of their higher risk for long-term and persistent depression."

Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership provided unrestricted funds for AVAIL, which was administered through collaboration with the American Heart Association.

The research was published in the American Heart Association’s journal Stroke.

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Review Date: 
March 29, 2012