During a median follow-up period of more than four years, 40 percent of survivors of intracerebral hemorrhage (ICH) developed a new-onset mood disorder, according to a longitudinal study.
Lead researcher Alessandro Biffi, MD, of Massachusetts General Hospital in Boston, presented the results on Feb. 22 at the American Stroke Association’s International Stroke Conference in Houston.
“Our study changes the way we look at depression after a hemorrhagic stroke,” Biffi said in a news release. “Depression is not just an isolated phenomenon following a hemorrhagic stroke. It may identify those who are likely to develop dementia, and this is important when these patients are evaluated, particularly in outpatient care settings.”
The study included 695 ICH survivors who had no history of depression. Half of the participants were women, while approximately 75 percent were white and most had known cardiovascular and cerebrovascular risk factors such as hypertension, diabetes or hyperlipidemia.
During the study, the researchers conducted telephone surveys every six months and asked participants about their mood, anxiety and cognitive performance.
After a median follow-up period of 49.6 months, 271 of the adults developed new-onset mood disorder. The estimated incidence rate for post-ICH depression was 6.9 percent per year.
The researchers found that independent risk factors for post-ICH depression included lower educational achievements, the APOE ε4 genotype and moderate or severe CT-defined white matter disease.
In addition, 135 adults had depression and dementia. Of those adults, 80 percent were diagnosed with depression before post-ICH dementia. The depression diagnosis occurred on average 17.5 months before the dementia diagnosis.
The researchers cited a few limitations of the study, including that they could not make causal inferences. They also mentioned that less than 20 percent of participants were minorities, so the results might not be generalizable to all ICH survivors. In addition, they did not capture apathy symptoms or mood symptoms’ severity.
“When caring for hemorrhagic stroke patients, healthcare providers tend to focus on preventing another stroke,” Biffi said in a news release. “We have found that even among patients who do not have a second stroke, the incidence of depression and subsequently dementia are very high, and healthcare providers need to be on the lookout for it in order to counsel patients and families.”
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.