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

Autor: Liu, Lu, Xu, Min, Marshall, Iain J., Wolfe, Charles DA, Wang, Yanzhong, O'Connell, Matthew DL
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Zdroj: PLoS Medicine; 3/28/2023, Vol. 19 Issue 3, p1-21, 21p, 1 Diagram, 6 Graphs
Abstrakt: 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. Lu Liu and colleagues present an updated systematic review and pooled analysis of depression after stroke. Author summary: Why was this study done?: Depression is common after stroke and depressed patients may be more likely to experience further health problems. How soon people become depressed after stroke and how many of them recover is unclear. What did the researhers do and find?: We performed an updated review and pooled meta-analysis of depression after stroke including 79 studies. The prevalence of poststroke depression by clinical interview was about 24%, which was slightly lower than that by rating scales (29%). Depression tends to occur within 3 months after stroke and has a high risk of becoming persistent. What do these findings mean?: Those with depression within 3 months after stroke may be likely to experience persistent depression. Targeted screening of patients at an early stage poststroke may be an opportunity to improve further health outcomes. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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