Sex differences in the prevalence of post-stroke depression: a systematic review

Objective: Depression after stroke occurs in 33% of individuals. It is grossly underdiagnosed and untreated. Sex differences in the prevalence of post-stroke depression (PSD) have not been adequately studied, and may have important implications for clinicians. Method: We performed a systematic review of five databases of all observational studies which measured the prevalence of PSD. Only those studies that stratified their results by sex were included. Results: Fifty-six publications including 47 primary studies between 1982 and 2006 met eligibility criteria and were included in the review. A total of 75131 subjects comprised these studies, with 11910 women and 62899 men. The prevalence of depression among women was higher in 35 studies. Moreover, the prevalence was generally higher among inpatient populations (both acute care and rehabilitation facilities) than community-dwelling subjects.
Conclusions: PSD is highly prevalent in both sexes, but appears to be slightly more common among women than men. Untreated depression after stroke can lead to a reduced quality of life, poorer prognosis and increased mortality. All stroke patients should be routinely screened for depression, and further research is needed to determine if there are sex-specific differences in response to treatment.