Depression after minor stroke: prevalence and predictors

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Abstract

Background and purpose:

Post-stroke depression (PSD) is one of the most frequent complications of stroke, with a prevalence ranging 20–60%. As PSD seems to be related to stroke severity, we hypothesized that the prevalence of PSD would be lower in patients with minor stroke.

Methods:

We investigated the prevalence and predictors of PSD over a 30-month follow-up period in a cohort of patients with minor ischaemic stroke (NIHSS ≤ 5).

Results:

We enrolled 105 patients (mean age 64.38 ± 11.2 years, M/F 69/36). PSD was diagnosed in 43 (41%) patients, 40 (93%) of whom had dysthymia; 22% of patients were already depressed at 1 month. The most frequent depressive symptoms (DSs) were working inhibition, indecisiveness, and fatigability. Patients who developed PSD were less educated (P = 0.044) and diabetic (P = 0.006). After excluding patients that were already depressed at 1 month, we performed a logistic regression model to detect predictors of PSD. Crying (P = 0.012, OR 1.067, CI 0.269–4.553) and guilt (P = 0.007, OR 0.037, CI 0.02ì03–0.401) at baseline were two DSs found to be significantly correlated with PSD. Higher educational level (P = 0.022, OR 0.084, CI 0.010–0.698) and diabetes (P = 0.007, OR 14.361, CI 2.040–101.108) were the risk factors significantly correlated with PSD.

Conclusion:

Post-stroke depression is frequent even in patients with minor stroke. Early detection of DSs might help to predict long-term development of PSD. No correlation was observed between lesion site or side and the development of PSD.

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