The positive effect of integrated care on depressive symptoms in stroke survivors

Cerebrovasc Dis. 2008;26(2):199-205. doi: 10.1159/000145328. Epub 2008 Jul 15.


Background: Depressive symptoms occur in approximately one-third of stroke patients. We sought to evaluate whether an integrated model of stroke care and secondary prevention reduced depressive symptomatology in stroke survivors.

Methods: The integrated care (IC) model is a multifaceted program that provides ongoing collaboration between a specialist stroke service and primary care physicians, using telephone tracking, a bi-directional information feedback loop, management of vascular risk factors, and regular screening for depressive symptoms.

Results: Patients exposed to the IC model exhibited significantly fewer depressive symptoms than controls at 12 months post stroke (as measured by the PHQ-9 screening tool; p = 0.006). At 12 months, 30/91 (33%) of the treatment group had depressive symptoms, compared to 52/95 (55%) of the control group (p = 0.003). With other variables adjusted for, the major associates of being depressed at 12 months were group allocation and physical disability.

Conclusion: The integrated care approach provides a framework for detecting and monitoring depressive symptoms, and appears to be protective against post-stroke depression.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use*
  • Combined Modality Therapy
  • Delivery of Health Care, Integrated*
  • Depression / diagnosis
  • Depression / etiology
  • Depression / prevention & control*
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team*
  • Patient Discharge
  • Patient Education as Topic
  • Psychiatric Status Rating Scales
  • Stroke / psychology*
  • Stroke / therapy
  • Survivors*
  • Time Factors
  • Treatment Outcome
  • Victoria


  • Antidepressive Agents