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Association of depression with 10-year poststroke mortality
P L Morris1, R G Robinson, P Andrzejewski
1Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, Baltimore.
The American Journal of Psychiatry
|January 1, 1993
Summary
Depression following stroke significantly increases mortality risk. Even minor depression in stroke survivors nearly quadrupled the odds of death within 10 years, especially for those with limited social contact.
Area of Science:
- Neurology
- Psychiatry
- Gerontology
Background:
- Depression is associated with increased mortality from natural causes, particularly in elderly individuals with physical illnesses.
- Stroke patients are a vulnerable population where the impact of depression on long-term outcomes requires investigation.
Purpose of the Study:
- To investigate the effect of depression on long-term mortality in a cohort of stroke patients.
- To determine if depression following stroke is an independent risk factor for increased mortality.
Main Methods:
- A series of 103 stroke patients were assessed for major or dysthymic depression using structured interviews and DSM-III criteria approximately two weeks post-stroke.
- Vital status of 91 patients was tracked over a 10-year follow-up period.
Main Results:
- The overall mortality rate after 10 years was 53% (48 out of 91 patients).
- Patients diagnosed with major or minor depression were 3.4 times more likely to die during follow-up compared to non-depressed patients.
- This association between depression and mortality remained significant even after accounting for factors like age, sex, social class, stroke type, lesion location, and social functioning.
Conclusions:
- Depressed mood after a stroke is a significant predictor of increased subsequent mortality.
- Stroke patients experiencing both depression and social isolation face a particularly high risk of mortality, with over 90% of such patients dying within the follow-up period.