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A meta-analysis of poststroke depression risk factors comparing depressive-related factors versus others

Published online by Cambridge University Press:  04 February 2020

Rebecca Perrain ,
Lila Mekaoui ,
David Calvet ,
Jean-Louis Mas  and
Philip Gorwood
Rebecca Perrain*
Affiliation:
Clinique des Maladies Mentales et de l’Encéphale, Sainte-Anne Hospital, GHU Paris – Psychiatrie & Neurosciences, Paris, France
Lila Mekaoui
Affiliation:
Clinique des Maladies Mentales et de l’Encéphale, Sainte-Anne Hospital, GHU Paris – Psychiatrie & Neurosciences, Paris, France
David Calvet
Affiliation:
Department of Neurology, Sainte-Anne Hospital, GHU Paris – Psychiatrie & Neurosciences, Université Paris-Descartes, DHU Neurovasc Sorbonne Paris Cité, INSERM U1266, Paris, France
Jean-Louis Mas
Affiliation:
Department of Neurology, Sainte-Anne Hospital, GHU Paris – Psychiatrie & Neurosciences, Université Paris-Descartes, DHU Neurovasc Sorbonne Paris Cité, INSERM U1266, Paris, France
Philip Gorwood
Affiliation:
Clinique des Maladies Mentales et de l’Encéphale, Sainte-Anne Hospital, GHU Paris – Psychiatrie & Neurosciences, Université Paris-Descartes Sorbonne Paris Cité, INSERM U1266, Paris, France
*
Correspondence should be addressed to: Rebecca Perrain, Clinique des Maladies Mentales et de l’Encéphale, Sainte-Anne Hospital, GHU Paris – Psychiatrie & Neurosciences, 100 rue de la Santé, 75674 Paris, Cedex 14, France. Phone: +33 01 45 65 87 06, +33 01 45 65 83.64; Fax: +33 01 45 65 76 56. Emails: rebecca.perrain@gmail.com, r.perrain@ghu-paris.fr.
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Abstract

Objectives:

Poststroke depression (PSD) is a public health issue, affecting one-third of stroke survivors, and is associated with multiple negative consequences. Reviews tried to identify PSD risk factors with discrepant results, highlighting the lack of comparability of the analyzed studies. We carried out a meta-analysis in order to identify clinical risk factors that can predict PSD.

Design:

PubMed and Web of Science were searched for papers. Only papers with a strictly defined Diagnostic and Statistical Manual of Mental Disorders depression assessment, at least 2 weeks after stroke, were selected. Two authors independently evaluated potentially eligible studies that were identified by our search and independently extracted data using standardized spreadsheets. Analyses were performed using MetaWin®, the role of each variable being given as a risk ratio (RR).

Results:

Eighteen studies were included in the meta-analysis. Identified risk factors for PSD with RR significantly above 1 were previous history of depression (RR 2.19, confidence interval (CI) 1.52–3.15), disability (RR 2.00, CI 1.58–2.52), previous history of stroke (RR 1.68, CI 1.06–2.66), aphasia (RR 1.47, CI 1.13–1.91), and female gender (RR 1.35, CI 1.14–1.61). Fixed effects model leads to identification of two more risk factors: early depressive symptoms with an RR of 2.32 (CI 1.43–3.79) and tobacco consumption (RR 1.40, CI 1.09–1.81). Time bias was found for alcohol consumption. Sample size was significantly involved to explain the role of “alcohol consumption” and “cognitive impairment.”

Conclusion:

Five items were significantly predictive of PSD. It might be of clinical interest that depressive-related risk factors (such as past depressive episodes) were having the largest impact.

Keywords

meta-analysisstrokepost-stroke depressiondepressionrisk factors

Information

Type
Review Article
Information
International Psychogeriatrics , Volume 32 , Special Issue 11: Issue Theme: Risk versus Protective Factors for Decline versus Well-Being , November 2020 , pp. 1331 - 1344
Copyright
© International Psychogeriatric Association 2020

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References

Aben, I., Lodder, J., Honig, A., Lousberg, R., Boreas, A. and Verhey, F. (2006). Focal or generalized vascular brain damage and vulnerability to depression after stroke: a 1-year prospective follow-up study. International Psychogeriatrics, 18, 19–35. doi: 10.1017/S104161020500270XCrossRefGoogle ScholarPubMed
Altieri, M. et al. (2012). Depression after minor stroke: prevalence and predictors. Journal of Psychosomatic Research, 19, 517–521. doi: 10.1111/j.1468-1331.2011.03583.xGoogle ScholarPubMed
Ayerbe, L., Ayis, S., Wolfe, C.D.A. and Rudd, A.G. (2013). Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. The British Journal of Psychiatry, 202, 14–21. doi: 10.1192/bjp.bp.111.107664CrossRefGoogle ScholarPubMed
Brodaty, H., Withall, A., Altendorf, A. and Sachdev, P. S. (2007). Rates of depression at 3 and 15 months poststroke and their relationship with cognitive decline: the Sydney Stroke Study. The American Journal of Geriatric Psychiatry, 15, 477–486. doi: 10.1097/JGP.0b013e3180590bcaCrossRefGoogle ScholarPubMed
Carota, A. et al. (2005). A prospective study of predictors of poststroke depression. Neurology, 64, 428–433. doi: 10.1212/01.WNL.0000150935.05940.2DCrossRefGoogle ScholarPubMed
Chatterjee, K., Fall, S. and Barer, D. (2010). Mood after stroke: a case control study of biochemical, neuro-imaging and socio-economic risk factors for major depression in stroke survivors. BMC Neurology, 10, 125. doi: 10.1186/1471-2377-10-125CrossRefGoogle ScholarPubMed
Fuentes, B., Ortiz, X., Sanjose, B., Frank, A. and Díez-Tejedor, E. (2009). Post-stroke depression: can we predict its development from the acute stroke phase? Acta Neurologica Scandinavica, 120, 150–156. doi: 10.1111/j.1600-0404.2008.01139.xCrossRefGoogle ScholarPubMed
Gorwood, P., Corruble, E., Falissard, B. and Goodwin, G. M. (2008). Toxic effects of depression on brain function: impairment of delayed recall and the cumulative length of depressive disorder in a large sample of depressed outpatients. American Journal of Psychiatry, 165, 731–739. doi: 10.1176/appi.ajp.2008.07040574CrossRefGoogle Scholar
Guiraud, V. et al. (2016). Depression predictors within six months of ischemic stroke: The DEPRESS Study. International Journal of Stroke, 11, 519–525. doi: 10.1177/1747493016632257CrossRefGoogle ScholarPubMed
Gyagenda, J. O. et al. (2015) Post-stroke depression among stroke survivors attending two hospitals in Kampala Uganda. African Health Sciences, 15, 1220–1231. doi: 10.4314/ahs.v15i4.22CrossRefGoogle ScholarPubMed
Hackett, M. L. and Pickles, K. (2014). Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International Journal of Stroke: Official Journal of the International Stroke Society, 9, 1017–1025. doi: 10.1111/ijs.12357CrossRefGoogle ScholarPubMed
Hammarström, A., Lehti, A., Danielsson, U., Bengs, C. and Johansson, E. E. (2009). Gender-related explanatory models of depression: a critical evaluation of medical articles. Public Health 123, 689–693. doi: 10.1016/j.puhe.2009.09.010CrossRefGoogle ScholarPubMed
Jiang, X. G., Lin, Y. and Li, Y. S. (2014). Correlative study on risk factors of depression among acute stroke patients. European Review for Medical and Pharmacological Sciences, 18, 1315–1323.Google Scholar
Kutlubaev, M. A. and Hackett, M. L. (2014). Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies. International Journal of Stroke: Official Journal of the International Stroke Society, 9, 1026–1036. doi: 10.1111/ijs.12356CrossRefGoogle ScholarPubMed
Lee, A. C. K., Tang, S. W., Yu, G. K. K. and Cheung, R. T. F. (2007). Incidence and predictors of depression after stroke (DAS). International Journal of Clinical Practice, 11, 200–206. doi: 10.1080/13651500601091212Google Scholar
Leentjens, A.F.G., Aben, I., Lodder, J. and Verhey, F.R.J. (2006). General and disease-specific risk factors for depression after ischemic stroke: a two-step Cox regression analysis. International Psychogeriatrics, 18, 739–748. doi: 10.1017/S1041610206003486CrossRefGoogle ScholarPubMed
Lewin-Richter, A., Volz, M., Jöbges, M. and Werheid, K. (2015). Predictivity of early depressive symptoms for post-stroke depression. The Journal of Nutrition, Health and Aging, 19, 754–758. doi: 10.1007/s12603-015-0540-xCrossRefGoogle ScholarPubMed
Ojagbemi, A., Akpa, O., Elugbadebo, F., Owolabi, M. and Ovbiagele, B. (2017). Depression after stroke in Sub-Saharan Africa: a systematic review and meta-analysis. Behavioural Neurology, 2017, 4160259. doi: 10.1155/2017/4160259CrossRefGoogle ScholarPubMed
Paolucci, S., Gandolfo, C., Provinciali, L., Torta, R., Toso, V. and DESTRO Study Group (2006). The Italian multicenter observational study on post-stroke depression (DESTRO). Journal of Neurology, 253, 556–562. doi: 10.1007/s00415-006-0058-6CrossRefGoogle Scholar
Provinciali, L., Paolucci, S., Torta, R., Toso, V., Gobbi, B. and Gandolfo, C. (2008). Depression after first-ever ischemic stroke: the prognostic role of neuroanatomic subtypes in clinical practice. Cerebrovascular Diseases (Basel, Switzerland), 26, 592–599. doi: 10.1159/000165112CrossRefGoogle ScholarPubMed
Rajashekaran, P., Pai, K., Thunga, R. and Unnikrishnan, B. (2013). Post-stroke depression and lesion location: a hospital based cross-sectional study. The Indian Journal of Psychiatry, 55, 343–348. doi: 10.4103/0019-5545.120546CrossRefGoogle ScholarPubMed
Robinson, R. G. and Jorge, R. E. (2016). Post-stroke depression: a review. The American Journal of Psychiatry, 173, 221–231. doi: 10.1176/appi.ajp.2015.15030363CrossRefGoogle ScholarPubMed
Rosenberg, M.S., Adams, D.C. and Gurevitch, J. (2000). MetaWin: Statistical Software for Meta-Analysis Version 2.0.Google Scholar
Sagen, U., Vik, T. G., Moum, T., Mørland, T., Finset, A. and Dammen, T. (2009). Screening for anxiety and depression after stroke: comparison of the hospital anxiety and depression scale and the Montgomery and Asberg depression rating scale. Journal of Psychosomatic Research, 67, 325–332. doi: 10.1016/j.jpsychores.2009.03.007CrossRefGoogle ScholarPubMed
Schöttke, H. and Giabbiconi, C.-M. (2015). Post-stroke depression and post-stroke anxiety: prevalence and predictors. International Psychogeriatric Association, 27, 1805–1812. doi: 10.1017/S1041610215000988CrossRefGoogle ScholarPubMed
Shi, Y. et al. (2015). Depression after minor stroke: prevalence and predictors. Journal of Psychosomatic Research, 79, 143–147. doi: 10.1016/j.jpsychores.2015.03.012CrossRefGoogle ScholarPubMed
Shi, Y., Yang, D., Zeng, Y. and Wu, W. (2017). Risk factors for post-stroke depression: a meta-analysis. Frontiers in Aging Neuroscience, 9, 218. doi: 10.3389/fnagi.2017.00218CrossRefGoogle ScholarPubMed
Tang, W. K. et al. (2005). Poststroke depression in Chinese patients: frequency, psychosocial, clinical, and radiological determinants. Journal of Geriatric Psychiatry and Neurology, 18, 45–51. doi: 10.1177/0891988704271764CrossRefGoogle ScholarPubMed
Tsai, C.-S., Wu, C.-L., Hung, T.-H., Chou, S.-Y. and Su, J.-A. (2016). Incidence and risk factors of poststroke depression in patients with acute ischemic stroke: a 1-year prospective study in Taiwan. Biomedical Journal, 39, 195–200. doi: 10.1016/j.bj.2015.10.004CrossRefGoogle ScholarPubMed
Vermeer, J., Rice, D., McIntyre, A., Viana, R., Macaluso, S. and Teasell, R. (2016). Correlates of depressive symptoms in individuals attending outpatient stroke clinics. Disability and Rehabilitation, 39, 43–49. doi: 10.3109/09638288.2016.1140837CrossRefGoogle ScholarPubMed
Volz, M., Möbus, J., Letsch, C. and Werheid, K. (2016). The influence of early depressive symptoms, social support and decreasing self-efficacy on depression 6 months post-stroke. Journal of Affective Disorders, 206, 252–255. doi: 10.1016/j.jad.2016.07.041CrossRefGoogle ScholarPubMed
Wei, N. et al. (2015). Post-stroke depression and lesion location: a systematic review. Journal of Neurology, 262, 81–90. doi: 10.1007/s00415-014-7534-1CrossRefGoogle ScholarPubMed
Wichowicz, H. M. et al. (2015). Clinical utility of chosen factors in predicting post-stroke depression: a one year follow-up. Psychiatria Polska, 49, 683–696. doi: 10.12740/PP/38439CrossRefGoogle ScholarPubMed
Yang, S. et al. (2015). A significant risk factor for poststroke depression: the depression-related subnetwork. Journal of Psychiatry & Neuroscience, 40, 259–268. doi: 10.1503/jpn.140086CrossRefGoogle ScholarPubMed
Zhang, N. et al. (2012). Time course of depression and one-year prognosis of patients with stroke in mainland China. CNS Neuroscience & Therapeutics, 18, 475–481. doi: 10.1111/j.1755-5949.2012.00312.xCrossRefGoogle ScholarPubMed
Zhang, T. et al. (2010). A prospective cohort study of the incidence and determinants of post-stroke depression among the mainland Chinese patients. Neurological Research, 32, 347–352. doi: 10.1179/016164110X12656393665125CrossRefGoogle ScholarPubMed