Depressive Symptoms and Risk of Acute Stroke: INTERSTROKE Case-Control Study.

< 0.001), with lowest prevalence in China (6.9% in controls) and highest in South America (32.2% of controls). In multivariable analyses pre-stroke depressive symptoms were associated with greater odds of acute stroke (OR 1.46, 95%CI 1.34-1.58), which was significant for both intracerebral hemorrhage (OR 1.56, 95%CI 1.28-1.91) and ischemic stroke (OR 1.44, 95%CI 1.31-1.58). A larger magnitude of association with stroke was seen in patients with a greater burden of depressive symptoms. While pre-admission depressive symptoms were not associated with a greater odds of worse baseline stroke severity (OR 1.02, 95%CI 0.94-1.10), they were associated with a greater odds of poor functional outcome at 1-month after acute stroke (OR 1.09, 95%CI 1.01-1.19).DiscussionIn this global study we recorded that depressive symptoms are an important risk factor for acute stroke, including both ischemic and hemorrhagic stroke. Pre-admission depressive symptoms were associated with poorer functional outcome, but not baseline stroke severity, suggesting an adverse role of depressive symptoms in post-stroke recovery.