Background: Because over one third of the patients who have had a stroke experience depression, researchers have focused their attention on this topic. However, studies have reported inconsistent results on the frequencies due to different definitions, populations, and assessment timing.
Objectives: To investigate the frequency, outcome, and management of depression after stroke.
Search Strategy: Following strategies and keywords recommended in the Cochrane Stroke Group methodology, the authors conducted computerized searches using various databases (e.g., MEDLINE, EMBASE, CLNAHL, PsychINFO, Applied Science and Technology Plus, etc.).
Selection criteria: Incidence studies and case series that have patients who met a standard diagnostic criterion on a standard mood scale or DSM-IIIR, DSM-IV were included.
Data collection and analysis: Data were collected by one reviewer and cross-checked by a second reviewer. The authors grouped selected studies into three categories based on case selection (population-based, hospital-based, and rehabilitation-based). For the purpose of statistical analysis, studies were classified according to case selection and the timing of the mood assessment.
Main results: A total of 96 reports from 51 studies were included in the review. The authors reported patient characteristics, a variety of methods used for diagnosis of depression, frequency of depression, and history of depression, antidepressants, and psychotherapy. Although there was a wide variation in the frequencies, the findings suggested that 33% of the people experienced depression after a stroke.
Conclusions: The authors proposed the possibility of under-reporting of depression, noting low numbers of stroke patients receiving treatment for depression (antidepressants or psychotherapy), variation in the cut-points, and multiple methods used to diagnose depression, as well as limited reliability of frequency comparisons between stroke patients and the control groups due to problems of study designs.