Patients with stroke or transient ischemic attack suffer high levels of depression and undertreatment with antidepressants
Depression is the most common psychiatric disorder affecting patients who have suffered a stroke. A new study reveals that patients with stroke or transient ischemic attack (TIA), a “ warning stroke” not usually associated with long-lasting functional deficit, have similar frequency of depression and newly identified depression between 3 and 12 months after hospitalization. The North Carolina researchers used a patient registry to identify depression and antidepressant medication use 3 and 12 months after hospitalization among 1,450 individuals with ischemic stroke and 397 individuals with TIA. Three months following hospitalization for stroke or TIA, 17.9 percent of stroke patients had depression compared to 14.3 percent of TIA patients; at 12 months, the percentages were 16.4 percent and 12.8 percent respectively. Persistent depression (diagnosis of depression at both 3 and 12 months) was present in 9.2 percent of those with stroke and 7.6 percent of those with TIA. A high proportion of patients with persistent depression was untreated with antidepressants (67.9 percent of those with stroke, 70 percent of those with TIA).
The risk of depression after even mild stroke or TIA was higher than the general population with a comparable age distribution. The researchers suggest that systematic evaluation for depression in patients with stroke or TIA may improve detection and treatment of this condition. This study was supported by AHRQ (HS16964).
See "Depression and antidepressant use after stroke and transient ischemic attack," by Nada El Husseini, M.D., Larry B. Goldstein, M.D., Eric D. Peterson, M.D., and others in Stroke 43, pp. 1609-1616, 2012.