Most stroke survivors receive no treatment for depression

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According to a study published in Neurology.

“As the leading cause of disability, depression negatively interferes with stroke treatment, hampers recovery from stroke, and increases risk of mortality,” Liming Dong, PhD, from the Department of Epidemiology at the University of Michigan School of Public Health, and colleagues wrote. “However, depression is largely undertreated in the stroke population.”

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Dong and colleagues sought to examine temporal trends in outpatient depression treatment among stroke survivors in the United States between 2004 and 2017, particularly for underrepresented sociodemographic groups who may experience treatment gaps and disparities in quality of life.

The study included 10,243 adult stroke survivors and 264,645 stroke-free adults drawn from the Medical Expenditure Panel Survey, a nationally representative survey conducted in the United States. Symptoms of depression were measured with the Patient Health Questionnaire-2, while sociodemographic characteristics included under 60, 60-74, and 75+), gender, race and ethnicity, family income, status health insurance and marital status. The researchers then looked at trends in outpatient treatment for depression and potential unmet need in the stroke population, including variations between sociodemographic subgroups, and compared them with people who did not have stroke. stroke.

The results showed that the rate of receiving outpatient treatment for depression among stroke survivors was 17.7% from 2004 to 2005 and 16% from 2016 to 2017 (adjusted OR of 0.90, 95% CI, 0.71 to 1.15). Older, male, black, and non-Hispanic Hispanic stroke survivors were less likely to receive treatment for depression. About two-thirds of stroke survivors who screened positive for depression received no outpatient treatment in a calendar year.

The data further revealed that sociodemographic disparities and the treatment gap persisted over the study period, which differed from the stroke-free population. Among stroke survivors who received treatment for depression, there was a significant increase in the use of psychotherapy (aOR 2.26, 95% CI 1.28-4.01), despite its less frequent use compared to drug therapy.

“This study shows that a significant number of survivors do not receive the help and support they need after a stroke,” Linda S. Williams, MD, researcher at Regenstrief and professor of neurology at Indiana University School of Medicine, said in a statement accompanying the study. “This rate has remained low for more than a decade, despite societal changes in attitudes toward mental health treatment.”


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