Poststroke Fatigue and Depression Are Related to Mortality in Young Adults: A Cohort Study.

Poststroke fatigue and depression are related to mortality in young adults: a cohort study.

BMJ Open. 2013; 3(3):
Naess H, Nyland H

To investigate the relationship between poststroke fatigue and depression and subsequent mortality in young ischaemic stroke patients in a population-based study.A prospective cohort study.All surviving young ischaemic stroke patients living in Hordaland County.Young ischaemic stroke patients aged 15-50 years at the time of the stroke were invited to a follow-up on an average 6 years after the index stroke. Psychosocial factors and risk factors were registered. Fatigue was self-assessed by the Fatigue Severity Scale (FSS). Depression was measured by Montgomery-Åsberg Depression Rating Scale (MADRS).No intervention was performed. PRIMARY AND SECONDARY OUTCOME MEASURE: Mortality on follow-up.In total, 190 patients were included. The mean age on follow-up was 48 years and subsequent follow-up period was 12 years. Cox regression analysis showed that mortality was associated with FSS score (p=0.005) after adjusting for age (p=0.06) and sex (p=0.19). Cox regression analysis showed that mortality was associated with MADRS score (p=0.006) after adjusting for age (p=0.10) and sex (p=0.11).Both fatigue and depression are associated with long-term mortality in young adults with ischaemic stroke. Depression may be linked to higher mortality because of psychosocial factors and unhealthy lifestyles whereas the link between fatigue and mortality is broader including connection to diabetes mellitus, myocardial infarction and psychosocial factors. HubMed – depression

Affective disorders and risk of developing dementia: systematic review.

Br J Psychiatry. 2013 Mar; 202: 177-86
da Silva J, Gonçalves-Pereira M, Xavier M, Mukaetova-Ladinska EB

Affective disorders are associated with cognitive disturbances but their role as risk factors for dementia is still not fully investigated.To evaluate the risk of developing dementia in individuals with a history of affective disorder.We conducted a systematic review of case-control and cohort studies addressing the risk of developing dementia in people with affective disorders. To the best of our knowledge, this is the first systematic review that has included studies evaluating this risk specifically in people with bipolar disorder.Fifty-one studies were included. Most of the studies found an increased risk for developing dementia in individuals with depression. Greater frequency and severity of depressive episodes seem to increase this risk. The evidence is contradictory regarding whether there is a difference in risk in people with early- or late-onset depression. The few available risk estimates for dementia in people with bipolar disorder suggest an even higher risk than for those with depression.Affective disorders appear to be associated with an increased risk of developing dementia, and one that is dependent on clinical and demographic variables. Depression may be both a prodrome and a risk factor for dementia. Future research should aim to elucidate the mechanisms that mediate these links. HubMed – depression

CHILD PROTECTION AND ADULT DEPRESSION: EVALUATING THE LONG-TERM CONSEQUENCES OF EVACUATING CHILDREN TO FOSTER CARE DURING WORLD WAR II.

Health Econ. 2013 Mar 4;
Santavirta N, Santavirta T

This paper combined data collected from war time government records with survey data including background characteristics, such as factors that affected eligibility, to examine the adult depression outcomes of individuals who were evacuated from Finland to temporary foster care in Sweden during World War II. Using war time government records and survey data for a random sample of 723 exposed individuals and 1321 matched unexposed individuals, the authors conducted least squares adjusted means comparison to examine the association between evacuation and adult depression (Beck Depression Inventory). The random sample was representative for the whole population of evacuees who returned to their biological families after World War II. The authors found no statistically significant difference in depressive symptoms during late adulthood between the two groups; for example, the exposed group had a 0.41 percentage points lower average Beck Depression Inventory score than the unexposed group (p?=?0.907). This study provides no support for family disruption during early childhood because of the onset of sudden shocks elevating depressive symptoms during late adulthood. Copyright © 2013 John Wiley & Sons, Ltd. HubMed – depression