Longitudinal prevalence and determinants of early mood disorder post-stroke

J Clin Neurosci. 2007 May;14(5):429-34. doi: 10.1016/j.jocn.2006.01.025. Epub 2007 Mar 2.


Background: Early identification of mood disorder post-stroke (MDPS) or its determinants could improve stroke outcomes. However, the natural history, prevalence and determinants of MDPS within the first weeks post-stroke require further investigation.

Methods: Consecutive hospitalised stroke survivors were assessed within 2-5 days of stroke, and at 1 and 3 months post-stroke. Baseline data included demographics, co-morbidities, stroke subtype, pre-stroke disability and cognition. At baseline, 1- and 3-month interviews physical impairment, disability, cognition and social support were assessed. MDPS was defined as a score of >8 on the depression subscale of the Hospital Anxiety Depression Scale. Factors independently associated with MDPS at each time-point were determined using regression analyses.

Results: One hundred and twenty-five subjects were included. The prevalence of MDPS within 5 days and at 1 and 3 months post-stroke was 5%, 16% and 21% respectively. The independent determinants for MDPS at 1 month were disability, social support and change in impairment score between initial and 1-month assessments; and at 3 months were disability, social support and institutionalisation. Individuals moved in and out of the subset of depressed patients over time. MDPS was independently associated with mortality at 3 months post-stroke.

Conclusion: Mood disorder post-stroke increases in prevalence over the initial weeks post-stroke despite an improvement in disability, and is associated with mortality. Patients with MDPS at 1 month were not necessarily affected at 3 months and vice versa, indicating the dynamic nature of MDPS in the early stages.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognition Disorders / etiology
  • Cognition Disorders / physiopathology
  • Disability Evaluation
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mood Disorders / diagnosis
  • Mood Disorders / epidemiology*
  • Mood Disorders / etiology*
  • Neuropsychological Tests / statistics & numerical data
  • Outcome Assessment, Health Care*
  • Prevalence
  • Severity of Illness Index
  • Stroke / complications*
  • Stroke / mortality
  • Time Factors