Comparison of treatment rates of depression after stroke versus myocardial infarction
- Objective Depression after stroke and myocardial infarction (MI) is common but often assumed to be undertreated without reliable evidence being available. Thus, we aimed to determine treatment rates and investigate the application of guidelines in these conditions. Methods Databases MEDLINE, EMBASE, PsycInfo, Web of Science, CINAHL, and Scopus were systematically searched without language restriction from inception to June 30, 2017. Prospective observational studies with consecutive recruitment reporting any antidepressant treatment in adults with depression after stroke or MI were included. Random-effects models were used to calculate pooled estimates of treatment rates. Results Fifty-five studies reported 32 stroke cohorts (n = 8938; pooled frequency of depression = 34%, 95% confidence interval [CI] = 29%-38%) and 17 MI cohorts (n = 10,767; pooled frequency of depression = 24%, 95% CI = 20%-28%). In 29 stroke cohorts, 24% (95% CI = 20%-27%) of 2280 depressed people used antidepressant medication. In 15 MI cohorts, 14% (95% CI =Objective Depression after stroke and myocardial infarction (MI) is common but often assumed to be undertreated without reliable evidence being available. Thus, we aimed to determine treatment rates and investigate the application of guidelines in these conditions. Methods Databases MEDLINE, EMBASE, PsycInfo, Web of Science, CINAHL, and Scopus were systematically searched without language restriction from inception to June 30, 2017. Prospective observational studies with consecutive recruitment reporting any antidepressant treatment in adults with depression after stroke or MI were included. Random-effects models were used to calculate pooled estimates of treatment rates. Results Fifty-five studies reported 32 stroke cohorts (n = 8938; pooled frequency of depression = 34%, 95% confidence interval [CI] = 29%-38%) and 17 MI cohorts (n = 10,767; pooled frequency of depression = 24%, 95% CI = 20%-28%). In 29 stroke cohorts, 24% (95% CI = 20%-27%) of 2280 depressed people used antidepressant medication. In 15 MI cohorts, 14% (95% CI = 8%-19%) of 2381 depressed people used antidepressant medication indicating a lower treatment rate than in stroke. Two studies reported use of psychosocial interventions, indicating that less than 10% of participants were treated. Conclusions Despite the high frequency of depression after stroke and MI and the existence of efficacious treatment strategies, people often remain untreated. Innovative strategies are needed to increase the use of effective antidepressive interventions in patients with cardiovascular disease.…
Author details: | Simon Ladwig, Zien Zhou, Ying Xu, Xia WangORCiD, Clara K. Chow, Katja WerheidGND, Maree L. Hackett |
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DOI: | https://doi.org/10.1097/PSY.0000000000000632 |
ISSN: | 0033-3174 |
ISSN: | 1534-7796 |
Pubmed ID: | https://pubmed.ncbi.nlm.nih.gov/30113911 |
Title of parent work (English): | Psychosomatic medicine |
Subtitle (English): | a systematic review and meta-analysis of observational data |
Publisher: | Lippincott Williams & Wilkins |
Place of publishing: | Philadelphia |
Publication type: | Review |
Language: | English |
Date of first publication: | 2018/07/23 |
Publication year: | 2018 |
Release date: | 2021/09/21 |
Tag: | depression; myocardial infarction; pharmacoepidemiology; stroke; treatment |
Volume: | 80 |
Issue: | 8 |
Number of pages: | 10 |
First page: | 754 |
Last Page: | 763 |
Funding institution: | Humboldt Research Track Scholarship; Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University; UNSW Sydney; National Health and Medical Research CouncilNational Health and Medical Research Council of Australia [APP1105447, APP1141328]; Heart Foundation Future Leader Fellowship; National Heart Foundation (Australia)National Heart Foundation of Australia [100034] |
Organizational units: | Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Psychologie |
DDC classification: | 1 Philosophie und Psychologie / 15 Psychologie / 150 Psychologie |