Depression in acute stroke: prevalence, dominant symptoms and associated factors. A systematic literature review

Abstract

Purpose. The aim of this review was to provide a comprehensive analysis of the state of knowledge about post-stroke depression (PSD) in the acute phase, focusing on: (a) the prevalence of depressive disorder and depressive symptoms, (b) the dominant depressive symptoms, (c) the factors associated with PSD and (d) the follow-up consequences.

Method. A computer-aided search in MEDLINE, CINAHL, PsychInfo, EMBASE, British Nursing index, Pub Med and Ovid Nursing Database was performed. We systematically searched for studies including depression within the first month after stroke.

Results. Forty articles including more than 5400 informants from 37 cohorts met the inclusion criteria. Only a few studies aimed to describe the nature of PSD. The prevalence of depressive disorder and depressive symptoms in the acute phase ranged widely from 5% to 54%. Multiple tools were used for measuring depressive symptoms in the acute phase. An association was found between early depressive symptoms and the continuation of PSD 12 months after stroke. There is a correlation between depressive symptoms and mortality at 12 and 24 months.

Conclusion. Depressive symptoms are common in the acute phase after stroke and associated with persistency of depression and mortality after 12 months. A gold standard for the measurement of depressive symptoms in relation to stroke is missing. The knowledge of PSD in the acute phase is still limited, and there is a need for continued empirical research on its profile and patterns.

Keywords:

• Stroke
• depression

Acknowledgements

We thank librarian Karin Bakkemo for her help and advice on the computer-aided search, and Thomas Harding (RN, PhD) for his linguistic advice regarding the manuscript.