Published Online
on March 4, 2004

A more recent version of this article appeared on April 1, 2004

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Submitted on September 9, 2003
Accepted on December 31, 2003

Self-Reported Depression and Use of Antidepressants After Stroke: A National Survey

Marie Eriksson MSc^*; Kjell Asplund MD, PhD; Eva-Lotta Glader MD, PhD; Bo Norrving MD, PhD; Birgitta Stegmayr PhD; Andreas Terént MD, PhD; Kerstin Hulter Åsberg MD, PhD; Per-Olov Wester MD, PhD; and for The Riks-Stroke Collaboration

From Department of Public Health and Clinical Medicine (M.E., K.A., E.-L.G., B.S., P.-O.W.), Umeå University, Sweden; Department of Clinical Neuroscience (B.N.), Lund University, Sweden; Department of Medical Science (A.T.), Uppsala University, Sweden; Department of Medicine (K.H.A.), Enköping Hospital, Sweden.

^* To whom correspondence should be addressed. E-mail: marie.eriksson{at}medicin.umu.se.

Background and Purpose--Depression after stroke is often described as underdiagnosed and undertreated. However, there are few data on self-reported depression and use of antidepressants in stroke patients at large.

Materials and Methods--In the Swedish national quality assessment register, Riks-Stroke, 15 747 stroke survivors are recorded. They were asked about depressive mood and antidepressant treatment 3 months after stroke. Age-specific prevalence of antidepressant use after stroke was calculated.

Results--At 3 months after stroke, 12.4% of male and 16.4% of female stroke survivors reported that they always or often felt depressed. In a multiple logistic regression model, female sex, age younger than 65 years, living alone, having had a recurrent stroke, being dependent on others, and institutional living 3 months after stroke were independent predictors of self-reported depression. Antidepressant medication was used by 22.5% of men and 28.1% of women who had had a stroke. Of patients using antidepressant drugs, 67.5% did not report depressive mood. However, 8.4% of the entire cohort reported depressive mood but no treatment with antidepressants. When compared with the general population, approximately twice as many of the stroke patients were using antidepressant treatment.

Conclusions--In this national survey, 1 in 7 patients reported that they felt depressed and the use of antidepressant drugs after stroke was common. The widespread use of antidepressants challenges the contention that antidepressants are generally underused after stroke. However, the substantial proportion reporting depressive mood but not using treatment with antidepressants suggests that patient selection for treatment should be more precise.

Key words: stroke • depression • antidepressive agents

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