Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis

Br J Psychiatry. 2013 Jan;202(1):14-21. doi: 10.1192/bjp.bp.111.107664.

Abstract

Background: Depression after stroke is a distressing problem that may be associated with other negative health outcomes.

Aims: To estimate the natural history, predictors and outcomes of depression after stroke.

Method: Studies published up to 31 August 2011 were searched and reviewed according to accepted criteria.

Results: Out of 13 558 references initially found, 50 studies were included. Prevalence of depression was 29% (95% CI 25-32), and remains stable up to 10 years after stroke, with a cumulative incidence of 39-52% within 5 years of stroke. The rate of recovery from depression among patients depressed a few months after stroke ranged from 15 to 57% 1 year after stroke. Major predictors of depression are disability, depression pre-stroke, cognitive impairment, stroke severity and anxiety. Lower quality of life, mortality and disability are independent outcomes of depression after stroke.

Conclusion: Interventions for depression and its potential outcomes are required.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Depressive Disorder / epidemiology*
  • Depressive Disorder / rehabilitation
  • Disease Progression
  • Epidemiologic Methods
  • Humans
  • Stroke / epidemiology*
  • Stroke / psychology
  • Stroke Rehabilitation
  • Time Factors
  • Treatment Outcome