Depression After Stroke: Most Patients Receive No Treatment

By Peter Zafirides, M.D. on April 01, 2012
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 Researchers call for routine depression screening.




People who have experienced a stroke or transient ischemic attack (TIA) experience high rates of depression, but the vast majority – nearly 70% – don’t receive proper treatment, according to new findings from Duke University Medical Center.


Nearly 1 in 5 Americans live with the effects of stroke, according to the National Stroke Association. Stroke occurs when a blood clot blocks an artery or a blood vessel breaks. When this occurs, blood flow to the brain can be severely interrupted. Stroke can kill brain cells and result in significant disability. Less is known about the incidence of TIA, which is defined as a brief episode of neurological dysfunction.


Finding Are “Striking” 


Daniel Laskowitz, M.D., a professor of medicine at Duke and the senior author of the study published today in the American Heart Association journal Stroke, called the relationship between depression and stroke, “striking.”


Because depression was just as common in TIA (which typically does not result in physical disability) and stroke, “the findings suggest this is not just a simple association between depression and the functional impairment typically associated with stroke,” Dr. Laskowitz said. Rather, several factors may be responsible. The brain injury associated with stroke and TIA might cause the depression, or the vascular risk factors that predispose patients to stroke and TIA may also put them at risk for depression.


The study included 1,450 adults with ischemic stroke and 397 with TIA from 99 hospitals in the U.S. Three months after hospitalization, depression affected nearly 18% of stroke patients and over 14%  of TIA patients. At 12 months, depression affected over 16% of stroke patients and 13% percent of TIA patients. Nearly 70% of stroke and TIA patients with persistent depression weren’t treated with antidepressant therapy at either the 3- or 12-month intervals.


Routine Screening Needed


“The high rates of undertreated depression seen in this study demonstrate the need for depression screening in these patient populations,” says Nada El Husseini, M.D, a stroke fellow at Duke and the first author of the study “It should become standard procedure to screen for depression after stroke and TIA.”


El Husseini also stresses that patients should be better informed about their increased risk for depression. “When I see patients in clinic, it’s rare for them to say they are feeling depressed. But if I ask them, they tell me how they feel. If they knew more about the association between depression, stroke and TIA, they may be more likely to bring up these symptoms with their providers.”


The results of this study should be a clarion call to health care providers to more actively screen for depression in the individuals they treat. Studies like this one at Duke can only help to raise the awareness of how – even today in 2012 – depression continues to be vastly undertreated in America.


April 1, 2012
The Healthy Mind Network 


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The above story contains original content and/or information reprinted and editorially adapted by The Healthy Mind. Material is provided by Duke University  and EurekAlerts

Image Credit: DigitalBob8 

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