Depression After Stroke Can Be Debilitating

THURSDAY March 27, 2008 -- Depression stops stroke victims from returning to work almost as often as physical disability does, Australian researchers report.

The study of 210 men and women, average age 55, who had paying jobs before a stroke found that 112 of them returned to work within six months -- about the same ratio as in a recent U.S. study, said researchers at the George Institute for International Health in Sydney. Their report appears in the March 28 issue of Stroke.

In developed countries, roughly 20 percent of stroke victims are still young enough to be part of the workforce, the researchers noted.

Of those study participants who went back to work, 71 percent were rated as physically independent. Thirty-three percent of those working were diagnosed with post-stroke depression, compared with 45 percent of those who had not returned to their jobs.

"Physicians should continually assess patients' mood after a stroke, because it's an important predictor of whether patients will go back to work," study author Dr. Nick Glozier said in a statement.

Only 30 percent of the stroke survivors with depression had received treatment for their psychiatric problem, the researchers found.

"We know that people who have gone through an illness such as a heart attack or stroke have a higher incidence of dysphoria or anxiety after the event," said Joanne Festa, an assistant professor of clinical neuropsychiatry at Columbia University who has done work on post-stroke depression.

"Having an acute illness such as a stroke in itself is upsetting," she said. "And, of course, with a stroke there is the possibility of cognitive impairment leading to depression. These people should be assessed, and any depression should be treated."

Younger patients in the Australian study were more likely to have post-stroke depression. Depression was more likely if the stroke was severe.

Family members should watch for signs of depression in someone recovering from a stroke, said Glozier, associate principal director of the institute. A physician should then be notified so that treatment might begin, he said.

"There is some evidence that antidepressants work in post-stroke depression, and there are indications that we may be able to prevent depression with psychological intervention, such as cognitive behavioral therapy-style motivational interviewing," he said.

A number of studies have found a high incidence of depression after stroke, sometimes in 70 or more percent of cases, Festa said.

Posted: March 2008


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