Mortality at 12 and 24 months after stroke may be associated with depressive symptoms at 1 month

Background and Purpose-Previous studies have reported mood symptoms after s troke to be a risk factor for later mortality. The purpose of the study was to examine whether mood symptoms at 1 month after stroke may be a risk fac tor for mortality at 12 and 24 months. Methods-As a cohort within a randomized controlled trial, 448 hospital pati ents were seen at 1 month after stroke and were randomized into a trial of psychological therapy. Follow-up was at 12 and 24 months. Mood symptoms wer e assessed by the Present State Examination and the General Health Question naire (GHQ)-28. Measures of disability before and after stroke and of cogni tive impairment after stroke were also taken at 1 month. Mortality was dete rmined at 12 and 24 months after stroke. Results-In logistic regression analyses, mortality at 12 months was associa ted unifactorally with scoring on the GHQ-D subscale (odds ratio [OR] 2.4, 95% CI 1.3 to 4.5) and scoring in the highest quartile of the GHQ (OR 3.1, 95% CI 1.1 to 8.8). In multiple logistic regression analyses, only GHQ-D re mained a significant predictor after controlling for other known predictors . At 24 months, scoring on GHQ-D (OR 2.4, 95% CI 1.4 to 4.1) and in the hig hest GHQ quartile (OR 2.2, 95% CI 1.0 to 4.8) was significantly associated with mortality in unifactoral analyses. Scoring on the GHQ-D remained a pre dictor of mortality after controlling for other variables. Psychiatric diso rder, such as major depression (according to International Classification o f Diseases, 10th Revision), was not statistically significantly associated with increased mortality at 12 or 24 months. Conclusions-Mood symptoms on a self-reported rating scale were associated w ith 12- and 24-month mortality after stroke, after adjustment for factors a ssociated with stroke severity. The result is in keeping with other evidenc e that depressive symptoms are a risk factor for death from vascular diseas e.