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Ischemic stroke and depression.

David W Desmond1, Robert H Remien, Joan T Moroney

  • 1Department of Neurology, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA. dwdesmond@usa.net

Journal of the International Neuropsychological Society : JINS
|April 2, 2003
PubMed
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Depression after ischemic stroke is less common than previously thought, affecting 11.2% of patients. Key factors include stroke severity, dementia, and female sex, with nonsomatic symptoms aiding diagnosis.

Area of Science:

  • Neurology
  • Psychiatry
  • Epidemiology

Background:

  • Previous depression after stroke studies show variable findings due to methodological differences.
  • Lack of stroke-free control groups hinders understanding of baseline depression rates.

Purpose of the Study:

  • Investigate the frequency and clinical determinants of post-stroke depression.
  • Address methodological limitations in prior research.

Main Methods:

  • Administered Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D) to 421 ischemic stroke patients and 249 controls.
  • Conducted neurological, neuropsychological, and functional assessments.
  • Defined depression with a SIGH-D score > 11.

Main Results:

Related Experiment Videos

  • Depression was less frequent (11.2% in stroke patients vs. 5.2% in controls), less severe, and less persistent than previously reported.
  • Depression associated with more severe stroke (especially limbic system involvement), dementia, and female sex.
  • Nonsomatic symptoms were more accurate for diagnosing depression post-stroke.

Conclusions:

  • Post-stroke depression may be less prevalent than previously estimated, potentially due to patient selection.
  • Stroke severity, dementia, and sex are significant determinants of depression after stroke.
  • Utilizing nonsomatic symptom assessment improves diagnostic accuracy for depression in stroke survivors.