Depression affects even transient ischemic attack patients
MedWire News: Post-stroke depression affects almost as many patients after a transient ischemic attack (TIA) as after a stroke, shows research.
And most patients with post-stroke depression are not given antidepressants, report Nada El Husseini (Duke University Medical Center, Durham, North Carolina, USA) and colleagues.
"Systematic evaluation for depression in patients with stroke or TIA may improve detection and treatment of this condition," they write in Stroke.
The findings arise from an analysis of 1847 patients from the AVAIL (Adherence eValuation After Ischemic stroke Longitudinal) study cohort, comprising 1450 patients who had ischemic stroke and 397 who had a TIA from 2006 to 2008.
Depression was defined as a score of at least 10 on the Patient Health Questionnaire-8. After excluding patients with previous stroke or TIA, depression was significantly more common in stroke than TIA patients at 3 months after onset, at 17.4% versus 12.4%, but not at 12 months, at 15.9% versus 12.0%.
Depression that was newly diagnosed between 3 and 12 months after stroke/TIA occurred in similar proportions of stroke and TIA patients, at 8.7% and 6.2%, respectively.
Persistent depression (present at both 3 and 12 months) occurred in 9.2% of stroke patients and 7.6% of TIA patients. But more than two-thirds of these patients were not using antidepressants at either 3 or 12 months, at 67.9% of stroke patients and 70.0% of TIA patients.
Patients were less likely to be persistently depressed with increasing age, decreasing level of disability at 3 months, and if they were working at 3 months.
Less than 2% of patients with persistent depression had it despite antidepressant use, which the researchers say "implies that depression in subjects with stroke and TIA is amenable to treatment or, alternatively, that antidepressants are used nonselectively in this population."
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By Eleanor McDermid