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Am J Psychiatry 1993; 150:124-129
Copyright © 1993 by American Psychiatric Association
Association of depression with 10-year poststroke mortality
PL Morris, RG Robinson, P Andrzejewski, J Samuels and TR Price
Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland, Baltimore.
OBJECTIVE: Depression has been linked to higher than expected mortality
from natural causes, particularly among elderly patients with physical
illness. The authors examined the effect of depression on mortality among a
group of stroke patients followed up for 10 years. METHOD: A consecutive
series of 103 patients was assessed for major or dysthymic (minor)
depression approximately 2 weeks after stroke with the use of a structured
mental status examination and DSM-III diagnostic criteria. Vital status was
determined for 91 of these patients 10 years later. RESULTS: Forty-eight
(53%) of the 91 patients had died. Patients with diagnoses of either major
or minor depression were 3.4 times more likely to have died during the
follow-up period than were nondepressed patients, and this relationship was
independent of other measured risk factors such as age, sex, social class,
type of stroke, lesion location, and level of social functioning. The
mortality rate among depressed patients with few social contacts was
especially high: over 90% had died. CONCLUSIONS: These results indicate
that depressed mood following stroke is associated with an increased risk
of subsequent mortality. Patients who are depressed and socially isolated
seem to be particularly vulnerable.
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