Affiliations: [a]
Stanford Stroke Center, Stanford, CA, USA
| [b] Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| [c] Department of Neurosurgery Stanford, Stanford University, CA, USA
Correspondence:
[*]
Address for correspondence: Marion Buckwalter, MD, PhD., MSLS Building, 1201 Welch Rd, Stanford, CA 94305-5489, USA. Tel.: +1 650 724 9098; Fax: +1 650 498 6262; E-mail: marion.buckwalter@stanford.edu.
Abstract: BACKGROUND: Poststroke depression is the most common psychiatric sequelae of stroke, and it’s independently associated with increased morbidity and mortality. Few studies have examined depression after intracranial hemorrhage (ICH). OBJECTIVE: To investigate the relationship between depression, ICH and outcomes. METHODS: A substudy of the prospective Diagnostic Accuracy of MRI in Spontaneous Intracerebral Hemorrhage (DASH) study, we included 89 subjects assessed for depression 1 year after hemorrhage. A Hamilton Depression Rating Scale score >10 defined depression. Univariate, multivariable, and trend analyses evaluated relationships between depression, clinical, radiographic, and inflammatory factors and modified Rankin score (mRS) at 90 days and one year. RESULTS: Prevalence of depression at one year was 15%. Depression was not associated with hematoma volumes, presence of IVH or admission NIHSS, nor with demographic factors. Despite this, depressed patients had worse 1-year outcomes (p = 0.004) and were less likely to improve between 3 and 12 months, and more likely to worsen (p = 0.042). CONCLUSION: This is the first study to investigate depression one year after ICH. Post-ICH depression was common and associated with late worsening of disability unrelated to initial hemorrhage severity. Further research is needed to understand whether depression is caused by worsened disability, or whether the converse is true.
