Depression prevalent in women after small vessel stroke

Patients with mild small vessel stroke (SVS) are nearly 7 times more likely to experience depression within 3 months of the incident stroke than those without a history of stroke, reveals a recent study.

In addition, the extent of white matter disease (WMD) shows no impact on poststroke depression (PSD), indicating that small vessel disease other than the incident SVS is not responsible for the increased rates of PSD. Interestingly, women are more likely to get depressed following SVS.

This retrospective analysis included a prospective cohort of patients enrolled in the American Stroke Association-Bugher SVS Study, which recruited 200 patients within 2 years of SVS and 79 controls without stroke history from 2007 to 2012 at four clinical sites. Patient Health Questionnaire-8 dichotomized at ≥10 and <10 with higher scores consistent with PSD was the primary outcome.

The investigators used chi-square test to compare the rates of depression between the two groups. They then evaluated factors associated with depression in patients with SVS, adjusted for age, sex, race/ethnicity, NIH Stroke Scale, WMD burden, Montreal Cognitive Assessment short-form score, and history of diabetes, using logistic regression.

Of the participants, 39 were excluded due to missing key variables. The mean time from stroke to depression screening was 74 days. Among those with SVS, 51 (31.7 percent) were diagnosed with PSD compared to five (6.3 percent) of controls (odds ratio [OR], 6.9, 95 percent confidence interval [CI], 2.6‒18.0; p<0.0001).

In addition, the prevalence of PSD was 35.9 percent among SVS patients who had good functional outcome (modified Rankin score ≤2). Notably, the only variable associated with PSD among those with SVS was female sex (OR, 2.3, 95 percent CI, 1.0‒5.2; p=0.041).