Increased Prevalence Of Early Post Stroke Depression Among Single Women

Introduction: Post stroke depression (PSD) is a common, yet under recognized sequelae of stroke. Detection and management of early PSD can enhance participation in rehabilitation and improve motor recovery. Early studies identified women as being at higher risk of developing PSD. Identifying gender specific features of PSD would assist better recognition and management of this syndrome. Our hypothesis was that PSD would be more common among women and gender differences would exist in features of PSD. Methods: Adult subjects admitted with ischemic stroke were recruited. The Beck Depression inventory II was administered between 30-90 days after the stroke. Depression symptoms and scores were analyzed by gender. Results: A total of 91 patients were included [Men: 42 (46.1%); Women 49 (53.9%); median age: men 55 (18-80) vs. women 57 (29-85); p 0.41]. Women had somewhat more diabetes (37.8% vs. 20.5% in men, p 0.08) and more likely to be single (68.7% vs. 42.5% in men, p 0.006). There was a high prevalence of early PSD, 42.8%. There was a higher frequency of PSD among women 49% vs. 35.7%, though not statistically significant. Women had a higher frequency of mild and moderate scores, whereas men had more severe PSD (figure). Both genders had similar scores for cognitive and somatic symptoms of depression. The most frequently reported symptoms were "loss of energy"(higher in women 89.8% vs. 71.4% in men, p 0.02), "fatigue", "loss of pleasure" and "change in sleep pattern"; similar among both genders. Among single women, median scores were 16 (0-53), more than double that of men: 7 (0-40); p 0.08. Scores in cognitive and somatic domains were higher among single women than single men. In conclusion, PSD is very frequent, affecting nearly half of female stroke patients, particularly if they are single. The symptoms may be somatic, affecting energy levels and sleep. Identification of patients at high risk of PSD will enable early treatment, with improved outcomes and quality of life.