Risk factors associated with post-stroke depression:
(1) family history of depressive, neurotic or anxiety disorder
(2) personal history of depressive, neurotic or anxiety disorder
(3) negative life events in the 6 months prior to the stroke (which would be a risk factor for pre-stroke depression)
(4) greater physical disability (impairment in activities of daily living, ADL)
(5) greater cognitive/intellectual impairment
(6) poor social support (living alone and few social contacts)
(7) history of previous stroke
(8) history of active alcohol abuse
Risk factors showing variable results between studies:
(1) location of the stroke (below)
(2) older age
(3) gender
Location of the stroke (Robinson, 2000, pages 1609):
(1) A stroke in the left frontal cortex or left basal ganglia is associated with major depression between 2 weeks and 2 months after the stroke.
(2) A stroke in the right frontal or right parietal cortices may be associated with depression.
(3) After 3 months the risk for depression was similar for both left and right-sided strokes.
(4) A patient with a recurrent stroke and with the previous stroke in the left frontal cortex or left basal ganglia (#1, above) has a high risk of depression, regardless of the location of the new stroke.
The impact of risk factors may vary with time interval after the stroke (Provinciali et al, 2002):
(1) In the first 3 months after the stroke, left anterior lesion (associated with language dysfunction) and living alone are important.
(2) After 3 months impairment in ADL is important.
(3) At 2-3 years post-stroke poor social contacts is important.
