Prestroke depression raises risk for poststroke depression

  • Taylor-Rowan M & al.
  • Psychol Med
  • 15 Aug 2018

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis suggests that the prevalence of prestroke depression is markedly lower than the depression prevalence observed after a stroke.
  • Prestroke depression is an important and relevant clinical variable regarding the development of poststroke depression.

Why this matters

  • The risk of developing depression is higher in patients with stroke and having depression prior to stroke only increases the risk.
  • On this basis, it is important that clinicians are aware of the relevance of prestroke depression to the potential development of depression poststroke.

Study design

  • Meta-analysis of 29 studies (n=1,64,993) identified after a search across Medline, EMBASE, psycINFO, Web of Science, and CINAHL databases.
  • Funding: Stroke Association and Chief Scientist Office Scotland.

Results

  • The pooled prevalence of prestroke depression was 11.6% (95% CI, 9.2-14.7).
  • Prevalence of prestroke depression with assessment method for clinical interview (17.3%; 95% CI, 13.1-22.6) was higher compared with method for self-reports (10.7%; 95% CI, 7.4-15.2) and medical record or charts (9.4%; 95% CI, 6.2-14.0).
  • Prestroke depression was associated with increased risk for poststroke depression (OR, 3.0; 95% CI, 2.3-4.0).
  • The strength of evidence to support estimate of association was ‘very low’.

Limitations

  • Heterogeneity among included studies.

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