Depressive Disorder, Dysthymia, and Risk of Stroke

Abstract

Background and Purpose-This study examined depressive disorder as a risk factor for incident stroke in a prospective, population-based design. Methods-The Baltimore Epidemiologic Catchment Area Study is a prospective 13-year follow-up of a probability sample of household residents from Baltimore, Md. Depressive disorder was measured with the diagnostic interview schedule, and stroke was assessed by questions from the health interview survey or by documentation on a death certificate. Results-During the 13-year follow-up of 1703 individuals, 66 strokes were reported and 29 strokes were identified by death certificate search. Individuals with a history of depressive disorder were 2.6 times more likely to report stroke than those without this disorder after controlling for heart disease, hypertension, diabetes, and current and previous use of tobacco. Medications used in the treatment of depressive disorder at baseline did not alter this finding. A history of dysthymia demonstrated a similar relationship to stroke, although the estimate was not statistically significant. Conclusions-Depressive disorder is a risk factor for stroke that appears to be independent of traditional cardiovascular risk factors. Further research on mechanisms for the association and the impact of treatment for depressive disorder on subsequent stroke is needed.

Selective Serotonin Reuptake Inhibitors and the Risk of Stroke

“…We speculate whether this indicates that prior depression might be a risk factor for stroke, a finding reported in a number of studies. [15][16][17] It is, however, still unknown whether depression before a clinical stroke is an independent stroke risk factor or a consequence of silent strokes. 18 The antiplatelet effect of SSRIs may occur only during treatment with high doses or after long-term exposure to SSRIs.…”

Circulating endothelial progenitor cells and depression: a possible novel link between heart and soul

“…9 Moreover, large-scale studies revealed an association between mood disorders and susceptibility to stroke. [10][11][12] However, although numerous theories have been proposed to explain the amplified risk of cardiovascular disease in patients with depression (reviewed by Everson-Rose and Lewis, 3 Lett et al 9 and Holtzheimer and Nemeroff 13 ), the exact biological mechanisms by which depression may increase the risk of cardiovascular events have not been completely elucidated so far.…”

Is Depression a Risk Factor of Worse Response to Therapy in Epilepsy?

“…While they are often considered to be a complication of these neurologic disorders, epidemiologic studies published in the last 15 years have suggested a bidirectional relation. Indeed, not only are these neurologic conditions associated with an increased risk of DD, but a history of depression has been associated with a four-to seven-fold higher risk of developing epilepsy (1) and a two-to three-fold higher risk of having a stroke, Parkinson's disease, or dementia (2)(3)(4). This bidirectional relation does not imply causality but reflects most likely the presence of common pathogenic mechanisms operant in DD and these neurologic disorders.…”