Gender differences in post-stroke depression: A longitudinal analysis of prevalence, persistence and predictive value of known risk factors

Post-stroke depression (PSD) is the most frequent psychiatric condition after stroke with a prevalence of approximately 33%. In the general population, depression is consistently reported to be more frequent in women than in men. Evidence about gender differences in PSD remains inconclusive and it is unknown if established risk factors exert gender-specific influence. The authors examined gender differences in PSD prevalence, persistence and influence of established risk factors using chi(2)- and Welch's t-tests and continuous-time structural equation modelling (CT-SEM). Patients (N = 301) from the longitudinal Berlin-PSD-study were assessed six weeks (baseline), and up to four times during the first 2.5 years post-stroke using DSM-5 depression criteria and the Geriatric Depression Scale (GDS). Established risk factors were assessed at baseline. Women showed higher PSD prevalence and severity at baseline (p < .01) but not thereafter (p >= .43). CT-SEM analysis revealed that known risk factors predicted depression, yet predictive value and persistence did not differ between genders. Our results showed that established PSD risk factors influence both genders to a similar extent and that in contrast to depression in the general population, gender differences in PSD prevalence and severity disappeared within six months post-stroke. Thus, for reasons yet to be deciphered, gender differences in PSD appear to be time-dependent after stroke.