Sex Differences in the Prevalence of Post-Stroke Depression: A Systematic Review

BackgroundDepression after stroke occurs in 33% of individuals. It is grossly underdiagnosed and untreated.ObjectiveThe authors studied sex differences in the prevalence of post-stroke depression (PSD), which have not been adequately studied, and may have important implications for clinicians.MethodThe authors performed a systematic review of five databases of all observational studies that stratified data by sex, measuring the prevalence of PSD.ResultsFiftysix publications, including 47 primary studies between 1982 and 2006, met eligibility criteria and were included in the review. A total of 75,131 subjects comprised these studies, with 11,910 women and 62,899 men.ResultsThe prevalence of depression among women was higher in 35 studies. Moreover, the prevalence was generally higher among inpatient populations (both in acute-care and rehabilitation facilities) than in community-dwelling subjects.ConclusionsPSD is highly prevalent in both sexes, but appears to be slightly more common among women than men. Untreated depression after stroke can lead to a reduced quality of life, poorer prognosis, and increased mortality. All stroke patients should be routinely screened for depression, and further research is needed to determine whether there are sex-specific differences in response to treatment.