Predictors of Post-Stroke Depression: A Retrospective Cohort Study

Area of Science:

• Neurology
• Psychiatry
• Epidemiology

Background:

• Post-stroke depression (PSD) is common, yet often underdiagnosed and undertreated.
• Identifying predictors of PSD is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To determine the incidence of depression in ischemic stroke patients.
• To identify demographic and clinical factors associated with the development of PSD.

Main Methods:

• Retrospective cohort study utilizing the Geisinger Neuroscience Ischemic Stroke (GNSIS) registry.
• Statistical analyses included Kaplan-Meier estimator and Cox proportional hazards models.
• Data from 5882 ischemic stroke patients were analyzed.

Main Results:

• The cumulative incidence of PSD within one year was 6.4% (95% CI 5.7−7.1%).
• Higher risk of PSD was observed in women (HR=1.47), patients with prior stroke (HR=1.58), myocardial infarction (HR=1.47), and Medicaid insurance (HR=2.16).
• Chronic stress, including financial and health-related stress, significantly increased PSD risk.

Conclusions:

• Women, individuals with a history of stroke or myocardial infarction, and those with Medicaid insurance are at increased risk for PSD.
• Findings underscore the significant impact of chronic stressors on PSD development.
• Improved screening and targeted interventions are needed for high-risk stroke populations.