Reader Response: Risk and Predictors of Depression Following Acute Ischemic Stroke in the Elderly

We read with great interest the article by Mayman et al.1 that showed a 55% greater risk of poststroke depression (PSD) than postmyocardial infarction depression. We suggest additional information that can be helpful for clinicians and researchers. First, Mayman et al.1 provided a combined analysis of Medicare inpatient, outpatient, and subacute nursing facility data. Transient mood changes, such as adjustment disorder with depressed mood, can influence screening for clinical depression in acute settings.2 Some variability in PSD rates may be noted based on the specific evaluation setting—for example, an inpatient hospital, a rehab center, or an outpatient clinic.3,4 We suggest stratified PSD analysis in different settings or adding treatment settings as a covariate in the regression analysis.

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