Study Details Risk Factors for Stroke-Related Depression

Patients with a history of depression or severe stroke have a high risk of developing depression within the year following hospitalization for stroke, according to a new study.

It is common for patients to experience depression after having a stroke. However, the risk factors and outcomes associated with depression after a stroke are less understood.
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To conduct their study, the researchers analyzed 157,243 patients aged 15 years and older who were hospitalized with a stroke from January 1, 2001, to December 31, 2011, who were registered with 7 Danish nationwide registries.

Those patients were then matched by age, sex, and municipality at time of stroke diagnosis to a reference group without stroke (n=160,236).

Using Cox proportional hazards regression analysis, the researchers examined the incidence of depression and mortality outcomes of depression.

Analysis showed that 25.4% of patients with a stroke and 7.8% of the reference group developed depression within 2 years after study entry.

Patients with a stroke were more likely to develop depression within the first 3 months after hospitalization than those in the reference group, but the incidence rate declined after 2 years.

The researchers also found that older age, female sex, single cohabitation status, basic educational attainment, diabetes, high level of somatic comorbidity, history of depression, and stroke severity were significant risk factors for depression in patients with a stroke.

After adjusting for confounders, depressed patients in both groups, especially those with new onset depression, had increased all-cause mortality rates. Depression-related mortality was about double in the reference population vs in the stroke population.

“Depression is common in patients with stroke during the first year after diagnosis, and those with prior depression or severe stroke are especially at risk,” the researchers concluded. “Because a large number of deaths can be attributable to depression after stroke, clinicians should be aware of this risk.”

—Amanda Balbi

Reference:

Jørgensen TSH, Wium-Andersen IK, Wium-Andersen MK, et al. Incidence of depression after stroke, and associated risk factors and mortality outcomes, in a large cohort of Danish patients [published online September 7, 2016]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2016.1932.