Severely Depressed Young Patients Have Over Five Times Increased Risk for Stroke: A 5-Year Follow-Up Study

Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Biological psychiatry (Impact Factor: 10.26). 09/2008; 64(10):912-5. DOI: 10.1016/j.biopsych.2008.07.006
Source: PubMed


This study aims to estimate the risk of developing stroke within 5 years of discharge among young patients ages 18 to approximately 44 who were hospitalized for depressive disorders.
Our study design features a study cohort and a comparison cohort. The study cohort included patients ages 18 to approximately 44 who were hospitalized with a principal diagnosis of depressive disorder (n = 827), whereas the comparison cohort consisted of 4,135 patients selected randomly (five for every depressed patient) and matched with the study group in terms of gender, age, and date of discharge. Each patient was tracked for 5 years after their discharge in 1998. Cox proportional hazard regressions were performed to compute the 5-year stroke-free survival rates after adjusting for possible confounding factors.
During the 5-year follow-up period, 50 depressed patients (6.05% of the study cohort) and 48 non-depressed subjects (1.16% of the comparison cohort) developed strokes. The adjusted hazard of stroke was 5.43 (95% confidence interval = 3.47-8.51, p < .001) times greater for depressed patients than for non-depressed subjects.
Our findings show young patients ages 18 to approximately 44 who were hospitalized for depressive disorders were at over five times greater risk of developing stroke within 5 years of discharge compared with non-depressed age- and gender-matched subjects.

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    • "Major depressive disorder (MDD) is increasingly recognized as a chronic, deteriorating illness with high comorbidity (Krishnan, 2003; Lee et al., 2008; Roose et al., 2001; Trivedi et al., 2007). Without sufficient treatment, residual symptoms of depression can lead to worsening outcomes, including higher relapse rates, suicidality (Kennedy and Paykel, 2004; Tranter et al., 2002; Trivedi et al., 2008), and diminished quality of life and psychosocial functioning (Hays et al., 1995; Kennedy and Paykel, 2004; McCall and Dunn, 2003). "
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    ABSTRACT: Depressive disorder (DD) is characterized by an inflammatory process and oxidative stress. Cyclooxygenase-2 (COX-2), the expression of which increases in depression, is an enzyme involved in inflammation and free radical processes. The aim of our study was to assess the correlation between single nucleotide polymorphism G-765C of the COX-2 gene and recurrent DD. The study was carried out in a group of 181 patients treated for recurrent DD, and in 149 healthy subjects of the control group (CG). Polymerase chain reaction/restriction fragment length polymorphism was used for genotyping. A statistically significant difference in genotype distribution was observed as a result of the comparison between the CG and the patients with DD. We demonstrated that the presence of the -765G allele in the COX-2 gene increased 2.1-fold the risk of DD development, whereas the presence of a homozygote (G-765G) in the analyzed gene increased the risk of DD development 2.5-fold. According to the obtained results, it may be proposed with some caution that the presence of both the -765G allele and the G-765G genotype in the COX-2 gene may confer a susceptibility to an increased risk of recurrent DD in the Polish population.
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