Risk of Depression Fivefold Increase in First Year After Stroke: "Higher in Younger Age, Men↑"

Samsung Seoul Hospital Research Team Analyzes 200,000 Stroke Patients
"Complex Effects of Social Pressure and Physiological Changes"

[Asia Economy Reporter Lee Gwan-ju] It has been revealed that the risk of developing depression is highest in the first year after a stroke occurs. The younger the age at onset, and the risk was higher in men than in women.

Professor Shin Dong-wook and Clinical Lecturer Choi Hye-rim from the Department of Family Medicine, and Professor Jeon Hong-jin from the Department of Psychiatry at Samsung Medical Center announced on the 6th that their research paper on this topic was recently published in the international journal International Journal of Environmental Research and Public Health.

The research team analyzed the characteristics of 207,678 patients who experienced a stroke between 2010 and 2018 based on National Health Insurance data, and then compared them with a matched cohort of 294,506 general population individuals selected considering age, gender, and other factors to analyze the impact of stroke on depression.

As a result, stroke patients had up to a 5.02-fold increased risk of developing depression in the first year compared to the control group, and the risk increased with the severity of disability, reaching up to 9.29 times higher in cases with severe disability. Since the risk tended to decrease over time, the research team emphasized the importance of addressing patients' mental health from the early stages of stroke treatment. First author Clinical Lecturer Choi Hye-rim explained, "Considering that the incidence of depression is highest within one year after experiencing a stroke, it is important to pay attention to and approach the risk of depression in stroke patients from the beginning."

Differences according to age and gender were also confirmed in this study. The risk of depression increased with the severity of post-stroke sequelae, and this characteristic was more pronounced in those under 65 years old and in men. Analyzing stroke patients with severe disability, those under 65 had a 5.39-fold higher risk of developing depression compared to the control group, whereas those aged 65 and older showed a 2.62-fold increase, showing a difference. Under the same conditions, men had a 3.78-fold higher risk of depression compared to the control group, while women had a lower risk at 2.92 times.

The research team interpreted these phenomena as a complex interaction of social pressure experienced by patients and physiological changes caused by stroke. They explained that frustration due to sequelae during a period of active social engagement had an impact. Professor Shin Dong-wook stated, "Stroke survivors in age and gender groups with a wide range of social activities may experience more depression due to social and economic pressures caused by stroke," and emphasized, "These patients should be monitored more closely during the treatment process."

The research team also reported that brain changes likely increased the risk of depression. This is because stroke causes a decrease in monoamines related to depression and an increase in glutamate, a neurotransmitter that causes excitotoxicity. Additionally, the reduction of gray matter in the brain, which affects emotion and cognitive function due to brain damage, was presumed to be a factor increasing the risk of depression in stroke patients. Professor Jeon Hong-jin said, "The social burden that can arise from depression is an important issue that cannot be overlooked in our country," and added, "Efforts and attention should be devoted to preventing depression so that stroke patients do not fall into deeper despair."