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Published on: May 22, 2019
Risk Factors for Post-stroke Depression: A Meta-analysis
Yu Shi1, Dongdong Yang2, Yanyan Zeng1
1Department of Rehabilitation, Zhujiang Hospital, Southern Medical UniversityGuangzhou, China.
Insights
Identifying risk factors for post-stroke depression (PSD) is crucial for rehabilitation. A history of mental illness, female gender, younger age, neuroticism, stroke severity, and handicap level increase PSD risk, while social support is protective.
Area of Science:
- Neurology
- Psychiatry
- Rehabilitation Medicine
Background:
- Post-stroke depression (PSD) significantly impedes physical and economic recovery after stroke.
- Identifying PSD risk factors is vital for effective stroke rehabilitation strategies.
- Previous research on PSD risk factors yields inconsistent results.
Purpose of the Study:
- To systematically identify and synthesize evidence-based risk factors for post-stroke depression (PSD).
- To provide a comprehensive overview of factors influencing PSD occurrence.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Medline, CENTRAL, EMBASE, Cochrane, Web of Science) from 1998 to 2016.
- Thirty-six studies were included after applying predefined inclusion/exclusion criteria.
- Meta-analysis was performed using RevMan 5.3, with study quality assessed using the Cochrane Risk of Bias tool.
Main Results:
- A history of mental illness emerged as the most significant modifiable risk factor for PSD.
- Other identified risk factors include female gender, younger age (<70 years), neuroticism, family history, stroke severity, and level of handicap.
- Social support was found to be a protective factor against PSD.
Conclusions:
- Multiple factors contribute to the development of post-stroke depression.
- Stroke severity and a prior mental health history are key predictors of PSD.
- Multifaceted prevention strategies involving social and family support are essential for managing PSD.
Abstract:
Background: Stroke not only impacts patients physically but also economically. Post-stroke depression (PSD), as a common complication of stroke, always obstructs the process of stroke rehabilitation. Accordingly, defining the risk factors associated with PSD has extraordinary importance. Although there have been many studies investigating the risk factors for PSD, the results are inconsistent. Objectives: The objectives of this study were to identify the risk factors for PSD by evidence-based medicine. Data sources: A systematic and comprehensive database search was performed of PubMed, Medline, CENTRAL, EMBASE.com, the Cochrane library and Web of Science for Literature, covering publications from January 1, 1998 to November 19, 2016. Study Selection: Studies on risk factors for PSD were identified, according to inclusion and exclusion criteria. The risk of bias tool, described in the Cochrane Handbook version 5.1.0, was used to assess the quality of each study. Meta-analysis was performed using RevMan 5.3 software. Results: Thirty-six studies were included for review. A history of mental illness was the highest ranking modifiable risk factor; other risk factors for PSD were female gender, age (<70 years), neuroticism, family history, severity of stroke, and level of handicap. Social support was a protective factor for PSD. Conclusion: There are many factors that have effects on PSD. The severity of stroke is an important factor in the occurrence of PSD. Mental history is a possible predictor of PSD. Prevention of PSD requires social and family participation.
