While nearly 1 in 5 people who suffer a stroke suffer from depression afterwards, almost 70 percent of patients do not receive any type of antidepressant medication. The researchers did not measure whether patients were receiving other kinds of treatment for depression, such as psychotherapy.
The researchers looked at 1,450 adults with a median age of 66 who suffered either from a stroke or a mini-stroke (called a “transient ischemic attack” or TIA). They used a common research depression measure called the Patient Health Questionnaire-8 (PHQ-8) to assess for depression.
The researchers found that about 18 percent of the stroke patients and more than 14 percent of the TIA patients were depressed three months after their hospitalization. A year after hospitalization for their stroke, those numbers declined by 1.5 and 0.5 percent, respectively.
But surprisingly, when the researchers asked whether stroke patients were receiving antidepressant medication treatment for depression, few were. Less than 30 percent of stroke patients were receiving some kind of antidepressant medication at both the 3-month and 12-month followups.
For reasons unknown, the researchers apparently did not assess whether patients were receiving other acceptable methods of treatment for depression, such as psychotherapy.
“Patients need to be open about their symptoms of depression and discuss them with their physicians so that they can work together to improve outcomes,” noted study co-author Dr. Nada El Husseini, a stroke fellow in the neurology division at Duke University Medical Center.
Most patients with stroke had only mild disability and only a few TIA patients had severe disability, but depression rates in both groups of patients were similar.
El Husseini believes that “it is important for physicians to screen for depression on follow-up after both stroke and TIA.”
“The similar rates of depression following stroke and TIA could be due to similarities in the rates of other medical conditions or to the direct effects of brain injury on the risk of depression, but more studies are needed,” El Husseini said.
The study participants came from the Adherence eValuation After Ischemic Stroke Longitudinal Study and patients in hospitals participating in the American Heart Association’s Get With The Guidelines-Stroke in 2006-08. The study included a geographically national representative group of 106 hospitals.
Symptoms of stroke and TIA include numbness or weakness in the face, arm, or leg; confusion; double vision or loss of vision; dizziness; and trouble walking or talking.
Symptoms of depression include loss of interest in activities that were once pleasurable, feelings of sadness, helplessness, hopelessness, sleep problems, and suicidal thoughts or actions.
The new study is published in the journal Stroke.