Post-stroke depression – prevalence and risk factors

Post-stroke depression (PSD) is the most common psychiatric complication after stroke. Intensive studies on PSD have been carried out since the mid-1970s. This paper presents a review of the literature on the prevalence and risk factors of PSD. Recent meta-analyses show that depression occurs in about 1/3 of patients after stroke. The risk factors for PSD can be divided into sociodemographic, genetic, connected with health status before stroke and connected with the stroke characteristics. Among sociodemographic factors, more frequent prevalence of PSD was observed in female sex in older age and with lack of social support. A genetic factor of PSD is a family history of depression. Genetic and molecular research revealed an association between PSD and the genes of the serotonin system (mainly the serotonin transporter gene) and with the brain-derived neurotrophic factor (BDNF) gene. The most important factors connected with health status before stroke that can predispose to PSD include prior history of depression, diabetes mellitus and smoking. Factors associated with stroke characteristics include stroke severity and recurrence, lesion location, and functional and cognitive impairment. Better knowledge concerning the prevalence and risk factors of PSD can be of help for diagnosis and also for initiating proper treatment and rehabilitation in stroke patients.