Prevalence and predictors of post-stroke mood disorders: A meta-analysis and meta-regression of depression, anxiety and adjustment disorder

To ascertain the prevalence and predictors of mood disorders, determined by structured clinical interviews (ICD or DSM criteria) in people after stroke. Major electronic databases were searched from inception to June 2016 for studies involving major depression (MDD), minor depression (MnD), dysthymi...

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Published in:General hospital psychiatry Vol. 47; pp. 48 - 60
Main Authors: Mitchell, Alex J., Sheth, Bhavisha, Gill, John, Yadegarfar, Motahare, Stubbs, Brendon, Yadegarfar, Mohammad, Meader, Nick
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.07.2017
Subjects:
Adjustment Disorders - epidemiology
Adjustment Disorders - etiology
Aged
Anxiety Disorders - epidemiology
Anxiety Disorders - etiology
Depression - epidemiology
Depression - etiology
Depressive Disorder - epidemiology
Depressive Disorder - etiology
Depressive Disorder, Major - epidemiology
Depressive Disorder, Major - etiology
Humans
Middle Aged
Prevalence
Prognosis
Psychiatry
Stroke - complications
Stroke - epidemiology
ISSN:0163-8343, 1873-7714, 1873-7714
Online Access:Get full text
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Summary:To ascertain the prevalence and predictors of mood disorders, determined by structured clinical interviews (ICD or DSM criteria) in people after stroke. Major electronic databases were searched from inception to June 2016 for studies involving major depression (MDD), minor depression (MnD), dysthymia, adjustment disorder, any depressive disorder (any depressive disorder) and anxiety disorders. Studies were combined using both random and fixed effects meta-analysis and results were stratified as appropriate. Depression was examined on 147 occasions from 2days to 7years after stroke (mean 6.87months, N=33 in acute, N=43 in rehabilitation and N=69 in the community/outpatients). Across 128 analyses involving 15,573 patients assessed for major depressive disorder (MDD), the point prevalence of depression was 17.7% (95% CI=15.6% to 20.0%) 0.65 analyses involving 9720 patients determined MnD was present in 13.1% in all settings (95% CI=10.9% to 15.8%). Dysthymia was present in 3.1% (95% CI=2.1% to 5.3%), adjustment disorder in 6.9% (95% CI=4.6 to 9.7%) and anxiety in 9.8% (95% CI=5.9% to 14.8%). Any depressive disorder was present in 33.5% (95% CI=30.3% to 36.8%). The relative risk of any depressive disorder was higher following left (dominant) hemisphere stroke, aphasia, and among people with a family history and past history of mood disorders. Depression, adjustment disorder and anxiety are common after stroke. Risk factors are aphasia, dominant hemispheric lesions and past personal/family history of depression but not time since stroke. Meta-regression on major depression and time since stroke. [Display omitted] •We conducted a meta-analysis of 128 studies involving 15,573 patients follow a stroke.•The point prevalence of major depression was 17.7% (95% CI=15.6% to 20.0%).•Any form of depression (ADD) was present in 33.5% (95% CI=30.3% to 36.8%).•Risk of depression was higher after left hemisphere stroke, aphasia, and past history of mood disorders.
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ISSN:0163-8343
1873-7714
1873-7714
DOI:10.1016/j.genhosppsych.2017.04.001