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Frequency and clinical determinants of poststroke depression
T Pohjasvaara1, A Leppävuori, I Siira
1Memory Research and Stroke Unit, Department of Clinical Neuroscience, Helsinki University Central Hospital and the Psychiatric Consultation Unit, Department of Psychiatry, University of Helsinki, Finland.
Stroke
|November 6, 1998
Summary
Post-stroke depression is common, affecting 40.1% of patients. Daily life dependency and prior depression history are key risk factors, highlighting the need for psychiatric screening in stroke survivors.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Post-stroke depression (PSD) frequency varies significantly due to differing methodologies.
- Previous studies lacked a consistent approach to patient populations, assessment tools, and diagnostic criteria.
Purpose of the Study:
- To determine the frequency of post-stroke depression in a large, well-defined cohort of ischemic stroke patients.
- To identify clinical correlates associated with depression following ischemic stroke.
Main Methods:
- A consecutive series of 486 ischemic stroke patients (aged 55-85) were studied.
- 277 patients received comprehensive psychiatric evaluations 3-4 months post-stroke using the Present State Examination.
- Diagnosis of depressive disorders followed the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised (DSM-III-R) criteria.
Main Results:
- The overall frequency of any depressive disorder was 40.1%.
- Major depression occurred in 26.0% and minor depression in 14.1% of patients.
- Dependency in daily life (OR, 1.8) and a history of previous depressive episodes (OR, 2.3) significantly correlated with depression diagnosis.
Conclusions:
- Clinically significant depression is a frequent complication after ischemic stroke.
- Psychiatric evaluation is crucial for post-stroke patients, particularly those with significant disability or a history of depression.
- Early identification and intervention for PSD are essential for patient recovery.