Risk Factors for Post-stroke Depression: A Meta-analysis

Abstract

Background: Stroke not only impacts patients physically but also economically. Post-stroke depression (PSD), as a common complication of stroke, always obstructs the process of stroke rehabilitation. Accordingly, defining the risk factors associated with PSD has extraordinary importance. Although there have been many studies investigating the risk factors for PSD, the results are inconsistent.Objectives: The objectives of this study were to identify the risk factors for PSD by evidence-based medicine.Data sources: A systematic and comprehensive database search was performed of PubMed, Medline, CENTRAL, EMBASE.com, the Cochrane library and Web of Science for Literature, covering publications from January 1, 1998 to November 19, 2016.Study Selection: Studies on risk factors for PSD were identified, according to inclusion and exclusion criteria. The risk of bias tool, described in the Cochrane Handbook version 5.1.0, was used to assess the quality of each study. Meta-analysis was performed using RevMan 5.3 software.Results: Thirty-six studies were included for review. A history of mental illness was the highest ranking modifiable risk factor; other risk factors for PSD were female gender, age (<70 years), neuroticism, family history, severity of stroke, and level of handicap. Social support was a protective factor for PSD.Conclusion: There are many factors that have effects on PSD. The severity of stroke is an important factor in the occurrence of PSD. Mental history is a possible predictor of PSD. Prevention of PSD requires social and family participation.

Anxiety and depression in patients who undergo a cerebrovascular procedure

“…Depression is experienced by 33 % of patients after a stroke [8]. Our large sample size and collection of many confounding variables allowed us to confirm that our results were unaffected even after removing stroke patients and those with migraines from our analysis.…”

Mental health burden after stroke: A propensity-score matched analysis of two population-based cohort studies

“…Finally, findings of this study add to an increasing body of literature showing that physical limitations and disability are important contributors to mental health in patients recovering from a stroke. For instance, a recent meta-analysis demonstrated that severity of stroke and level of handicap were important predictors of post-stroke depression (Shi et al, 2017). In addition, a study comparing patients after stroke and myocardial infarction reported that the higher incidence of depression after stroke could be attributed to the higher level of handicap following stroke (Aben et al, 2003).…”

Anxiety-Depressive Disorders in Patients After Stroke: Prevalence, Approaches to Diagnosis and Therapy

“…В ряде работ показано, что тревожно-депрессивные нарушения более выражены в пожилом возрасте [21]. Другие авторы сообщают, что в острой стадии инсульта тревожно-депрессивные нарушения, напротив, чаще отмечаются у молодых пациентов [22]. Противоречивы сведения и о связи тревожно-депрессивных симптомов постинсультной депрессии и пола.…”

“…В то же время есть данные, что депрессия у мужчин протекает тяжелее и реже регрессирует. Предположительно, мужчины психологически хуже адаптируются к утрате трудоспособности, что приводит к более выраженным эмоциональным нарушениям [22,23]. К депрессии после инсульта предрасполагают некоторые особенности семейного положения, а именно вдовство, развод или одинокий образ жизни [21].…”