Prevalence and natural history of depression after stroke: A systematic review and meta-analysis of observational studies

Yes, we've known of post stroke depression for years. QUIT TELLING US IT EXISTS AND JUST FUCKING SOLVE IT BY PREVENTION! 

You prevent it by having 100% recovery protocols.

Your patients will be too busy counting reps and looking forward to recovery. This was totally useless.

 

Prevalence and natural history of depression after stroke: A systematic review and meta-analysis of observational studies

• Lu Liu, 
• Min Xu, 
• Iain J. Marshall, 
• Charles DA Wolfe, 
• Yanzhong Wang, 
• Matthew DL O’Connell

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• Published: March 28, 2023
• https://doi.org/10.1371/journal.pmed.1004200
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Abstract

Background

Depression is the most frequent psychiatric condition after stroke and is associated with negative health outcomes. We aim to undertake a systematic review and meta-analysis of the prevalence and natural history of depression after stroke.

Methods and findings

Studies published up to 4 November 2022 on Medline, Embase, PsycINFO, and Web of Science Core Collection were searched. We included studies of adults with stroke, where depression was assessed at a prespecified time point. Studies excluding people with aphasia and history of depression are excluded. Critical Appraisal Skills Programme(CASP) cohort study tool was used to assess risk of bias. A total of 77 studies were included in the pooled estimates of the prevalence of poststroke depression (PSD). The overall prevalence of depression was 27% (95% CI 25 to 30). Prevalence of depression was 24% (95% CI 21 to 28) by clinical interview and 29% (95% CI 25 to 32) by rating scales. Twenty-four studies with more than one assessment time point reported the natural history of PSD. Among people who were depressed within 3 months of stroke, 53% (95% CI 47 to 59) experienced persistent depression, while 44% (95% CI 38 to 50) recovered. The incidence of later depression (3 to 12 months after stroke) was 9% (95% CI 7 to 12). The cumulative incidence during 1 year after stroke was 38% (95% CI 33 to 43), and the majority (71% (95% CI 65 to 76)) of depression had onset within 3 months after stroke. The main limitation of the present study is that excluding people in source studies with severe impairments may produce imprecise estimates of the prevalence of PSD.

Conclusions

In this study, we observed that stroke survivors with early-onset depression (within 3 months after stroke) are at high risks for remaining depressed and make up two-thirds of the incident cases during 1 year after stroke. This highlights the need for ongoing clinical monitoring of patients depressed shortly after stroke.

Trial Registration

PROSPERO CRD42022314146.