Women Twice as Likely as Men to Suffer Severe Depression After a Stroke, Data Show

Findings appearing a in European journal show that a fifth of women who suffer a stroke experience severe depression, compared with only 10% of men, and that patterns of symptoms differed between the genders over time.

Depending on the severity, a stroke can be one of the most debilitating medical events in a person’s life. It happens when blood flow to the brain is blocked, caused by a clot or ruptured blood vessel. It can interfere with speech, mobility, and a person’s ability to work. Rehabilitation and caregiving may be required, so depression and anxiety are common afterward, according to the Stroke Foundation.

The study in the European Journal of Neurology followed the progress of 2313 people (1275 men and 1038 women) for 5 years after they had a stroke. Patients were recruited and tracked for the South London Stroke Register between 1998 and 2016, and they were followed until July 2017. Researchers from King’s College London used the Hospital Anxiety and Depression Scale and matched their health and demographic data to evaluate the participants.

Lead author Salma Ayis from King’s College School of Population Health and Environmental Sciences said the following patterns emerged:

• Three different trajectories were identified in men, and 4 trajectories were identified in women; a small group (4.82%) of women had very severe depressive symptoms.
• Severe symptoms in women were double those in men.
• Moderate symptoms in men became worse over time (46.5% of patients). Women’s symptoms were stable on all trajectories.
• Increased symptoms of depression were associated with higher mortality rates.

“While we cannot pinpoint exactly why depression is more common among women, it could be that women draw more of their sense of self and self-worth from their social relationships and so are more sensitive to challenges in maintaining those,” Ayis said in a statement. “As women live longer, they are more exposed to loneliness, poor physical health and loss of support, all of which could lead to depression.”

The common thread, she said, is the lack of likelihood of survival as symptoms increase, which calls for better monitoring by clinicians.

Reference

Ayis SA, Rudd AG, Ayerbe L, et al. Sex differences in trajectories of depression symptoms and associations with 10‐year mortality in patients with stroke: the South London Stroke Register [published online January 7, 2019]. Euro J Neurol. doi: 10.1111/ene.13899.