Post-stroke depression (PSD) is a common complication affecting stroke survivors, but data on its long-term course and recurrence rates are limited. A recent prospective study from the U.K. provides valuable insights into the incidence and recurrence of PSD over an 18-year period, highlighting the importance of routine depression screening in stroke survivors. This study was published in the journal of Lancet Regional Health – Europe. The study was conducted by Liu L. and colleagues.
PSD can have significant implications for the recovery and quality of life of stroke survivors, yet it often goes unrecognized and untreated. Understanding the timing and recurrence patterns of depression following stroke is crucial for implementing effective interventions and support strategies.
Researchers analyzed data from the South London Stroke Register, including 3,864 stroke survivors assessed for depression over 18 years. Depression was measured using the Hospital Anxiety and Depression Scale, and patients were followed up to assess recurrence rates and long-term outcomes.
The key findings of the study were:
• The cumulative incidence of PSD over 18 years was 59.4%, with 87.9% of cases occurring within the first 5 years post-stroke.
• Within 3 months, 33.4% of PSD cases were identified, increasing to 54.6% within 1 year.
• Recurrence of depression was common, with 66.7% of patients experiencing recurrence, predominantly within 5 years of recovery.
• Patients with severe depression had lower recovery rates and higher recurrence rates compared to those with mild depression.
• Routine screening for depression within 5 years post-stroke is recommended, as depression can begin as early as 3 months post-stroke.
The study highlights the significant burden of PSD in stroke survivors and underscores the need for long-term monitoring and support. Early detection and intervention for depression can improve outcomes and enhance the overall well-being of stroke survivors.
Post-stroke depression is prevalent, with the majority of cases occurring within the first 5 years post-stroke. Routine screening for depression in stroke survivors is crucial for timely identification and management of this common complication. Long-term follow-up and support are essential to address the high recurrence rates observed in this population.
Reference:
Liu L, et al "Natural history of depression up to 18 years after stroke: a population-based South London Stroke Register study" Lancet Reg Health Eur 2024; DOI: 10. 1016/j.lanepe.2024. 100882.