Analysis of nearly 30 wide-ranging studies, involving more than 300,000 patients showed that depression is significantly linked to a higher risk of stroke and stroke related death. This report was published by researchers from Boston in the form of an article in the JAMA journal.
Brain stroke, according to the definition of the World Health Organization (WHO), is a clinical syndrome associated with sudden onset of focal (or generalised) brain activity disorder, continued longer than 24 hours or leading to the death and not due to a cause other than vascular. Brain strokes can be divided to ischemic and haemorrhagic. Brain stroke is one of the most commonly occurring diseases of the nervous system, and because of its consequences remains a serious medical problem. In the scale of the world they constitute the reason for 9% of all deaths and are second in terms of frequency, cause of death, after heart disease. Brain stroke morbidity rate (standardized to the European population aged 45 to 84 years) is estimated from 240/100,000 to 600/100,000 inhabitants per year. Mortality rates due to stroke, standardized for age, differ quite considerably depending on the country. The amount in the population of women aged 35 to 74 years differs from 20/100,000 to 112/100,000, in population of men in this age range, these rates are from 34/100,000 to 178/100,000.
Depression is linked with chronic and sustained despondence, low self-esteem and loss of ability to feel pleasure. It commonly manifests itself in individuals between 15 and 30 years old and affects 10% of the population. Approximately 25% of the depression episodes lasts less than a month, and 50% less than 3 months. Almost 75% of patients complain about symptoms of depression during the two years from the previous episode. Genetic, environmental and behavioural factors are at the ground of this disease. Depression is often secondary to other illnesses, especially chronic. Threatening is the fact, that untreated depression may lead to suicide. Approximately 15% of the individuals commit suicide, over 50% of attempt to end their lives, and almost 80% have suicidal thoughts.
Scientists from Boston performed a systematic review of the literature and meta-analysis of prospective cohort studied evaluating the relationship of depression with brain stroke and stroke related death. They published the results of this scientific assessment in a prestigious JAMA journal. The analysis included 28 studies enrolling 317,540 patients, 8 478 episodes of stroke during the observation period from 2 to 29 years. When the results of all studies were combined, it turned out that depression is associated with a 45% increase in risk of stroke, 55% increase in risk of fatal stroke and 25% increase in risk of ischemic stroke. Risk of haemorrhagic stroke in the course of depression is not increased significantly. It’s not explained how depression affects the occurrence of stroke. Probably the relationship of these diseases is complex and has a neuroendocrine-immunological basis. The sociologic-psychological aspect is not without significance: the reluctance to seek for medical assistance, lack of interest in their own health, lack of physical activity, obesity. In order to accurately describe this phenomenon, further studies are needed. Misery loves company?
Written by: Karolina Kłoda MD, PhD
Source:
1. A. Pan, Q. Sun, O. I. Okereke, K. M. Rexrode, F. B. Hu. Depression and Risk of Stroke Morbidity and Mortality: A Meta-analysis and Systematic Review. JAMA: The Journal of the American Medical Association, 2011; 306 (11): 1241 DOI: 10.1001/jama.2011.1282
2. ScienceDaily. Retrieved July 9, 2012, from http://www.sciencedaily.com /releases/2011/09/110920163211.htm
3. http://medtube.net/tribune/a-novel-gene-associated-with-depression-identified/
4. http://medtube.net/other/medical-videos/499-stroke-evaluation-simulation-1
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