Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis
Depression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with pos...
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| Veröffentlicht in: | Psychological medicine 2019-03, Vol.49 (4), p.685-696 |
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| creator | Taylor-Rowan, Martin Momoh, Oyiza Ayerbe, Luis Evans, Jonathan J. Stott, David J. Quinn, Terence J. |
| description | Depression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with post-stroke depression.
We searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via 'GRADE'.
Of 11 884 studies identified, 29 were included (total participants n = 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2-14.7]; range: 0.4-24% (I2 95.8). Prevalence of pre-stroke depression varied by assessment method (p = 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3-4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was 'very low'.
One in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression.Protocol identifierPROSPERO identifier: CRD42017065544. |
| doi_str_mv | 10.1017/S0033291718002003 |
| format | Article |
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We searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via 'GRADE'.
Of 11 884 studies identified, 29 were included (total participants n = 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2-14.7]; range: 0.4-24% (I2 95.8). Prevalence of pre-stroke depression varied by assessment method (p = 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3-4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was 'very low'.
One in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression.Protocol identifierPROSPERO identifier: CRD42017065544.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291718002003</identifier><identifier>PMID: 30107864</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Associations ; Bias ; Clinical assessment ; Clinical interviews ; Confidence intervals ; Depression - epidemiology ; Depression - etiology ; Emotional disorders ; Epidemiology ; Humans ; Mental depression ; Meta-analysis ; Original Articles ; Patients ; Prevalence ; Risk assessment ; Search strategies ; Self report ; Stroke ; Stroke - complications ; Stroke - psychology ; Systematic review</subject><ispartof>Psychological medicine, 2019-03, Vol.49 (4), p.685-696</ispartof><rights>Copyright © Cambridge University Press 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-508f4abe9b30736bbb5d164d90bf5988da8dceeb0cc528ca2aa232c6bf8a8ed83</citedby><cites>FETCH-LOGICAL-c416t-508f4abe9b30736bbb5d164d90bf5988da8dceeb0cc528ca2aa232c6bf8a8ed83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0033291718002003/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,776,780,12825,27901,27902,30976,55603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30107864$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taylor-Rowan, Martin</creatorcontrib><creatorcontrib>Momoh, Oyiza</creatorcontrib><creatorcontrib>Ayerbe, Luis</creatorcontrib><creatorcontrib>Evans, Jonathan J.</creatorcontrib><creatorcontrib>Stott, David J.</creatorcontrib><creatorcontrib>Quinn, Terence J.</creatorcontrib><title>Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>Depression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with post-stroke depression.
We searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via 'GRADE'.
Of 11 884 studies identified, 29 were included (total participants n = 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2-14.7]; range: 0.4-24% (I2 95.8). Prevalence of pre-stroke depression varied by assessment method (p = 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3-4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was 'very low'.
One in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression.Protocol identifierPROSPERO identifier: CRD42017065544.</description><subject>Associations</subject><subject>Bias</subject><subject>Clinical assessment</subject><subject>Clinical interviews</subject><subject>Confidence intervals</subject><subject>Depression - epidemiology</subject><subject>Depression - etiology</subject><subject>Emotional disorders</subject><subject>Epidemiology</subject><subject>Humans</subject><subject>Mental depression</subject><subject>Meta-analysis</subject><subject>Original Articles</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Risk assessment</subject><subject>Search strategies</subject><subject>Self report</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - psychology</subject><subject>Systematic review</subject><issn>0033-2917</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kV1rFTEQhoMo9rT6A7wpAW-82ZqP_ch6J8XWQkHB9nqZJLOaurs5ZnIsx1_fHHu0YPEqTOaZZwZexl5JcSKF7N5-EUJr1ctOGiFUKZ6wlazbvjJ9Z56y1a5d7foH7JDoRgipZa2eswMtpOhMW6_Yr88Jf8KEi0MeR75OWFFO8Ttyj6UgCnHhsHgeMnEgii5A3v3dhvyNryPlx_w7Dpy2lHEuqONlQcDb35IZM1SwwLSlQC_YsxEmwpf794hdn324Ov1YXX46vzh9f1m5Wra5aoQZa7DYWy063VprGy_b2vfCjk1vjAfjHaIVzjXKOFAASivX2tGAQW_0EXtz712n-GODlIc5kMNpggXjhgYljOnqVve6oK__QW_iJpV7CyU70yjRaFkoeU-5FIkSjsM6hRnSdpBi2AUzPAqmzBzvzRs7o_878SeJAui9FGabgv-KD7v_r70DjJKaJQ</recordid><startdate>201903</startdate><enddate>201903</enddate><creator>Taylor-Rowan, Martin</creator><creator>Momoh, Oyiza</creator><creator>Ayerbe, Luis</creator><creator>Evans, Jonathan J.</creator><creator>Stott, David J.</creator><creator>Quinn, Terence J.</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7QP</scope><scope>7QR</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201903</creationdate><title>Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis</title><author>Taylor-Rowan, Martin ; 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Med</addtitle><date>2019-03</date><risdate>2019</risdate><volume>49</volume><issue>4</issue><spage>685</spage><epage>696</epage><pages>685-696</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><abstract>Depression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with post-stroke depression.
We searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via 'GRADE'.
Of 11 884 studies identified, 29 were included (total participants n = 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2-14.7]; range: 0.4-24% (I2 95.8). Prevalence of pre-stroke depression varied by assessment method (p = 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3-4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was 'very low'.
One in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression.Protocol identifierPROSPERO identifier: CRD42017065544.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>30107864</pmid><doi>10.1017/S0033291718002003</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Psychological medicine, 2019-03, Vol.49 (4), p.685-696 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Cambridge University Press Journals Complete |
| subjects | Associations Bias Clinical assessment Clinical interviews Confidence intervals Depression - epidemiology Depression - etiology Emotional disorders Epidemiology Humans Mental depression Meta-analysis Original Articles Patients Prevalence Risk assessment Search strategies Self report Stroke Stroke - complications Stroke - psychology Systematic review |
| title | Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis |
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