New study: post-stroke depression underestimated and undertreated

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“Depression and anxiety are common after stroke, affecting one third of stroke survivors. Depression often goes unrecognised and untreated,” explained Jennifer H White, University of Newcastle, Australia, at the 21st Meeting of the European Neurological Society (ENS) in Lisbon.

“Post stroke depression is commonly associated with higher levels of disability and low social support. Rehabilitation must not only focus on the physical recovery of post-stroke patients but also address mental health more seriously. On-going depression can be debilitating to quality of life if it goes untreated,” said White. The study shows that anxiety tends to resolve over time while depression can persist if it remains untreated.

 

The long-term experience of depression

 

This longitudinal cohort study conducted by the Australian research group aimed to explore the predictors of post-stroke depression and anxiety. The scientists looked at factors contributing to a change in symptoms of 134 stroke survivors over a 12 months period. The survivors were asked to participate in face-to-face interviews exploring mood disturbance, physical function, quality of life, social support and community participation at stroke onset and at 3, 6, 9 and 12 months afterward.

 

Onset of post-stroke depression predictable

 

Results highlight that a past history of depression and low community participation are factors that predict the onset of post-stroke depression. No factors were found that predict the resolution of post-stroke depression. Anxiety seems to get better over time, whereas untreated depression remains an on-going burden to all persons concerned, patients and family. “Our study suggests that stroke survivors require long-term psychological monitoring and early intervention strategies addressing disability and low social support,” White stressed. Treating clinicians should consider counselling for patients and their families and low threshold introduction of anti-depressants if necessary. “Better access to on-going rehabilitation should take into consideration the individual needs of each stroke survivor as well as other potential life stressors that might compound the experience of stroke.”