OBJECTIVES: Post-stroke depression (PSD) is common among stroke survivors and is associated with increased morbidity and mortality. Little is understood about racial/ethnic differences in PSD detection. This study assessed the racial/ethnic disparities in PSD detection in a national cohort of Department of Veterans Affairs (VA) acute stroke patients. METHODS: The study included VA patients who: received inpatient care for acute stroke within 2001; survived >60 days post-index hospitalization; had an index stay <365 days; and were confirmed VA healthcare enrollees. PSD was established if a patient had a depression diagnosis in VA or Medicare inpatient or outpatient files, or was dispensed an antidepressant with guideline recommended minimum daily dosage during the 12 months post stroke. A multivariate logistic regression model was fitted to estimate the effects of race/ethnicity on PSD detection, adjusting for sociodemographic and clinical factors. RESULTS: The study cohort (N = 5825) was comprised of 66% white, 22% black, 7% Hispanic, and 6% for all other racial/ethnic categories. Among these stroke patients, 39% had PSD. Black and 'all other' racial/ethnic categories were significantly less likely to be diagnosed with PSD than non-Hispanic whites, even adjusting for potential risk factors. CONCLUSION: White, non-Hispanic VA acute stroke patients were more likely to be diagnosed with PSD, even controlling for sociodemographic and clinical characteristics. Whether these findings suggest racial/ethnic differences in symptom endorsement by patients or in symptom recognition by providers is not clear.
OBJECTIVES: Post-stroke depression (PSD) is common among stroke survivors and is associated with increased morbidity and mortality. Little is understood about racial/ethnic differences in PSD detection. This study assessed the racial/ethnic disparities in PSD detection in a national cohort of Department of Veterans Affairs (VA) acute strokepatients. METHODS: The study included VA patients who: received inpatient care for acute stroke within 2001; survived >60 days post-index hospitalization; had an index stay <365 days; and were confirmed VA healthcare enrollees. PSD was established if a patient had a depression diagnosis in VA or Medicare inpatient or outpatient files, or was dispensed an antidepressant with guideline recommended minimum daily dosage during the 12 months post stroke. A multivariate logistic regression model was fitted to estimate the effects of race/ethnicity on PSD detection, adjusting for sociodemographic and clinical factors. RESULTS: The study cohort (N = 5825) was comprised of 66% white, 22% black, 7% Hispanic, and 6% for all other racial/ethnic categories. Among these strokepatients, 39% had PSD. Black and 'all other' racial/ethnic categories were significantly less likely to be diagnosed with PSD than non-Hispanic whites, even adjusting for potential risk factors. CONCLUSION: White, non-Hispanic VA acute strokepatients were more likely to be diagnosed with PSD, even controlling for sociodemographic and clinical characteristics. Whether these findings suggest racial/ethnic differences in symptom endorsement by patients or in symptom recognition by providers is not clear.
Authors: Gabrielle M Harris; Janice Collins-McNeil; Qing Yang; Vu Q C Nguyen; Mark A Hirsch; Charles F Rhoads; Tami Guerrier; J George Thomas; Terrence M Pugh; Deanna Hamm; Carol Pereira; Janet Prvu Bettger Journal: J Stroke Cerebrovasc Dis Date: 2016-10-06 Impact factor: 2.136
Authors: Kezhen Fei; Emma K T Benn; Rennie Negron; Guedy Arniella; Stanley Tuhrim; Carol R Horowitz Journal: Stroke Date: 2015-12-01 Impact factor: 7.914
Authors: Lesli E Skolarus; Lynda D Lisabeth; James F Burke; Deborah A Levine; Lewis B Morgenstern; Linda S Williams; Paul N Pfeiffer; Devin L Brown Journal: Ethn Dis Date: 2015 Impact factor: 1.847
Authors: Gina L Evans-Hudnall; Melinda A Stanley; Allison N Clark; Amber L Bush; Ken Resnicow; Yu Liu; Joseph S Kass; Angelle M Sander Journal: J Behav Med Date: 2012-12-08