Stroke: poststroke depression was common.

Clinical bottom line (level 1b)

  1. A sixth of patients who had a stroke have major depression within 12 months.
  2. A quarter of patients who had a stroke will minor depression within 12 months.
  3. In patients with depression, scores on neurological deficit tests were worse at 12 months than in patients without depression.
Kauhanen et al: Stroke 1999; 30: 1875-1880
Expires February 2003

The study

Prospective cohort study with unblinded, unobjective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: stroke unit of a university hospital, Finland

106 patients (aged range 19 to 82 years; mean 66, 57% male) first-ever brain infarction

Excluded if
  • alcoholism
  • transient ischaemic attack
  • previous psychiatric illnesses
  • central nervous system disorders




    • 87% followed for 12 months
    Outcomes studied:
  • major depression according to DSM-III-R criteria
  • minor depression

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    major depression 12 months 15/92 16.3%
    (8.76% to 23.9%)
    minor depression 12 months 24/92 26.1%
    (17.1% to 35.1%)

    • There was a statistically significant difference in verbal logical thinking, nonverbal problem solving, verbal memory, visual memory, attention and executive functions and visuoconstructive functions scores at 12 months between patients who were not depressed and those who were.

    Comments

    1. The relationship between functional outcome, social status and support, and other medications (e.g. beta-blockers) is not examined, and all factors may strongly influence the results.

    Citation

    1. Kauhanen ML, Korpelainen JT, Hiltunen P, et al: Poststroke depression correlates with cognitive impairment and neurological deficits. Stroke 1999; 30: 1875-1880
    Contributor: Clare Wotton and Musab Hayatli, February 2000
    Reviewer: Wai-Lam Chan

    Clinical Question.
    Patient first-ever ischaemic stroke
    Intervention or Exposure depression
    Comparison no depression
    Outcome neurological deficit