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Is Post-Stroke Depression Different from Post-MI Depression?
After adjustment for variables, stroke and MI patients had the same cumulative incidence of depression, which raises questions about whether stroke specifically causes depression.
Researchers have speculated that particular lesions caused by stroke can predispose patients to depression. To learn more about a possible association between depression and stroke, these researchers compared the incidence of depression over one year in 190 patients suffering a first cerebral infarct (mean age, 69; 47% female) with the incidence of depression in 200 patients suffering a first myocardial infarct (MI; mean age, 60; 23% female). Participants were consecutive emergency-room patients with stroke or MI. Those with prior depression, other current psychiatric disorders, dementia, aphasia, or general frailty were excluded. Standardized rating scales were used to determine depression incidence.
Cumulative one-year incidence of depression was found to be 39% in stroke patients and 28% in MI patients (P=0.06). This difference, however, disappeared when the researchers controlled for sex, age, and level of handicap. In approximately half of the depressed patients in each group, depression developed during the first month after stroke or MI.
Comment: These results raise questions about the specificity of stroke -- or of particular stroke-associated lesions -- as a cause of depression. Still, stroke and MI share many vascular risk factors (e.g., hypertension, increased serum cholesterol, and diabetes); it remains possible that the high rate of depression in both conditions represents a common cerebrovascular mechanism. The depression in both conditions could also signify a general stress-precipitated reaction.
— Gary Tucker, MD
Published in Journal Watch Psychiatry July 9, 2003
Citation(s):
Aben I et al. A comparative study into the one year cumulative incidence of depression after stroke and myocardial infarction. J Neurol Neurosurg Psychiatry 2003 May; 74:581-5.
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