New Zealand research to help reduce depression amongst stroke victims

Every year thousands of New Zealanders have a stroke and about a third of them experience “post-stroke depression”, something a researcher at The University of Auckland is hoping she can change.

Maree Hackett, from the Faculty of Medical and Health Sciences’ Clinical Trials Research Unit, is studying mood and psychological problems in people who have had a stroke for her PhD studies.

Her work is part of the Auckland Regional Community Stroke Study (ARCOS), funded by the Health Research Council, which has involved interviews with nearly 2000 people from the Bombay Hills to Wellsford who experienced a stroke in 2002 and 2003.

The stroke study includes a baseline interview with stroke survivors, or a representative (usually a family member), soon after their stroke, and follow up interviews at 28 days, and six months to a year later. Ms Hackett is using data from the study to try and understand who is most likely to suffer from depression and what sort of treatment is received.

“People say it isn’t surprising that someone is depressed or suffers from emotionalism after a stroke because they have been through a massive shock. But this research is about trying to improve the quality of life for people and understanding the risk factors,” she says.

Stroke is a serious disease and is now recognised as one of the leading global health burdens. It is also the third biggest killer in New Zealand, according to the Stroke Foundation of New Zealand.

“Strokes can affect people of all ages, but is mainly a disease of older people, so with our ageing population, improving quality of life for stroke victims is something we need to take action on.

“If we can reduce depression amongst stroke victims, we can hopefully improve their rehabilitation and reduce the high mortality rates,” she says.

Ms Hackett’s work involves evaluations of the ARCOS Study participants to identify a group of depression risk factors. From that, she hopes to produce a predictive model — which may include variables such as age, sex, history of depression, lifestyle factors and personality traits – to analyse a patient’s risk.

“If we know who is at risk then we can implement some preventive strategies for those people early on to limit the development of depression.

“Part of my research is to work out the role that drugs and therapy could play in reducing depression rates and what the most effective action for certain patients would be,” she says.

Ms Hackett says treating stroke patients can be particularly difficult as many have ongoing physical problems and may be on other medication.

As part of her PhD work, Ms Hackett has written three academic reviews, called Cochrane Reviews, on past research into pharmacological and psychological interventions for treating and preventing depression after stroke.

“There has been a lot of work done in this area, but none that has as much high quality data as in the ARCOS study. So there is still little evidence of what can be done to prevent or treat depression after stroke or who is most likely to suffer from depression or emotionalism,” she says.

The results from Ms Hackett’s Cochrane Reviews were released publicly at the Fifth World Stroke Congress in Canada in late June. She will complete her PhD study in 2005.