Pessimists more prone to post-stroke depression

October 03, 2002

DALLAS, Oct. 4 - It may be best to look on the bright side - at least when recovering from a stroke. Stroke survivors with a high degree of pessimism are nearly five times more likely to develop post-stroke depression, according to a Dutch study reported in the October issue of Stroke: Journal of the American Heart Association.

Depression is common among stroke survivors and can interfere with recovery. "Our study found that post-stroke depression is not only caused by damage to the brain tissue but also depends on one's general tendency to react to distressing life events by experiencing emotions such as anger, anxiety and sadness," says lead author Ivo Aben, M.D.

Aben was a Ph.D. student while conducting his research for this study at the Institute of Brain and Behavior at Maastricht University, in the Netherlands.

Researchers assessed 190 people recovering from a first stroke for depressive symptoms at one, three, six, nine and 12 months after the stroke. Survivors also completed questionnaires covering the five main personality traits: the tendency to experience negative mood states - called neuroticism, extraversion, openness to new experiences, agreeableness and conscientiousness. They responded to statements such as "I seldom feel lonely or sad," "I smile easily," and "I really like talking to people" on a five-point scale ranging from "strongly agree" to "strongly disagree."

At one-year after stroke, researchers found that 38.7 percent of the survivors were depressed. Those with the high neuroticism scores had a 4.6 times higher risk of developing post-stroke depression than those with the low scores. This effect was stronger in men than in women.

Neuroticism was the only personality trait that increased the risk of post-stroke depression. The survivor's level of disability was the only other factor that also had an independent risk of increasing post-stroke depression.

The effect of negative emotions was independent of other factors such as patients' age, gender, location of the brain tissue affected, the level of disability and a prior episode of depression, he notes.

Future research should also examine whether early psychological interventions such as emotional support and alternative coping strategies in survivors with high levels of neuroticism can prevent depression, he says.
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Co-authors include Johan Denollet, Ph.D.; Richel Lousberg, Ph.D.; Frans Verhey, M.D., Ph.D.; Franz Wojciechowski, Ph.D.; and Adriaan Honig, M.D.

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