RISK-FACTORS FOR POSTSTROKE DEPRESSION

Objective. To examine possible risk factors in post-stroke depression (PSD) other than site of lesion in the brain Data sources. 191 first-e ver stroke patients were examined physically shortly after their strok e and examined psychiatrically and physically 4 months post-stroke. Se tting. A geographically defined segment of the metropolitan area of Pe rth, Western Australia, from which all strokes over a course of 18 mon ths were examined (the Perth Community Stroke Study). Measures. Psychi atric Assessment Schedule, Mini Mental State Examination, Barthel Inde x, Frenchay Activities Index, physical illness and sociodemographic da ta were collected. Post-stroke depression (PSD) included both major de pression and minor depression (dysthymia without the 2-year time stipu lation) according to DSM-III (American Psychiatric Association) criter ia. Patients depressed at the time of the stroke were excluded. Patien ts. 191 first-ever stroke patients, 111M, 80F, 28% had PSD, 17% major and 11% minor depression. Results. Significant associations with PSD a t 4 months were major functional impairment, living in a nursing home, being divorced and having a high pre-stroke alcohol intake (M only). There was no significant association with age, sex, social class, cogn itive impairment or pre-stroke physical illness. Conclusion. Results f avoured the hypothesis that depression in an unselected group of strok e patients is no more common, and of no more specific aetiology, than it is among elderly patients with other physical illness.