In yet another example of the mind-body connection, people with depression symptoms may face an increased risk of having a stroke, as well as a worse recovery afterwards.

A new international study, published online March 8 in the journal Neurology, found about 18% of those who had a stroke had symptoms of depression, compared to 14% of those who did not have a stroke.

After adjusting for other contributing factors, researchers determined that people with symptoms of depression before stroke had an overall 46% increased risk of stroke compared to those with no symptoms of depression.

As the symptoms increased, so did the higher risk of stroke.

“Depression affects people around the world and can have a wide range of impacts across a person’s life,” said study author Dr. Robert Murphy, of the University of Galway in Ireland.

“Our study provides a broad picture of depression and its link to risk of stroke by looking at a number of factors including participants’ symptoms, life choices and antidepressant use,” Murphy said in a journal news release. “Our results show depressive symptoms were linked to increased stroke risk and the risk was similar across different age groups and around the world.”

The researchers used data from more than 26,000 adults in the INTERSTROKE study, which included 32 countries across Europe, Asia, North and South America, the Middle East and Africa.

More than 13,000 of the participants had a stroke. They were matched with more than 13,000 people who had not had a stroke but were similar in their age, sex, racial or ethnic identity.

Information was collected about depression symptoms in the year prior to the study, including whether participants had felt sad, blue or depressed for two or more consecutive weeks in the previous 12 months.

Participants also answered questions at the beginning of the study about cardiovascular risk factors, including high blood pressure and diabetes.

Researchers found that people who reported five or more symptoms of depression had a 54% higher risk of stroke than those with no symptoms. Those who reported three to four symptoms of depression had 58% higher risk and those who reported one or two symptoms of depression had a 35% higher risk.

The people who had depression symptoms weren’t more likely to have severe strokes. They were, however, more likely to have worse outcomes a month after the stroke.

A study limitation is that depression symptoms were assessed only at the start of the study and not over time.

“In this study, we gained deeper insights into how depressive symptoms can contribute to stroke,” Murphy said. “Our results show that symptoms of depression can have an impact on mental health, but also increase the risk of stroke. Physicians should be looking for these symptoms of depression and can use this information to help guide health initiatives focused on stroke prevention.”

More information

The American Stroke Association has more on depression and stroke.

SOURCE: American Academy of Neurology, news release, March 8, 2023