Table 1: Articles suitable for meta-analysis.

StudyCountryParticipants RecruitmentDepression after stroke assessmentFollowupReported results on mortality

Almeida and Xiao, 2007 [8] Australia574
males 55%
Patients with first-ever diagnosis of stroke from January to December 1990First diagnosis of ICD-9 and ICD-10 depressive disorders recorded during the 24 months following the stroke10 yearsRR: 1.72 (0.98–3.01)
HR: 1.26 (0.71–2.23)
depression versus control without mental disorder

Ellis et al., 2010 [9] USA124
males 48%
Participants between 25 and 74 years with stroke diagnosis from NHANES I Epidemiologic Followup Study (NHEFS) interviewed in 1982Center for Epidemiologic Studies Depression Scale (CES-D) ≥ 168 yearsMortality rate (per 1000):
105.1 versus 84.7
depression versus no depression

House et al., 2001 [10] UK448
males 54%
Patients with definite clinical diagnosis of stroke (not
subarachnoid hemorrhage) from a randomized controlled trial
ICD-10 major depression at 1 month after stroke, according to Present State Examination12 and 24 months OR at 12 months:
1.3 (0.65–2.7)
major depression
OR at 24 months:
1.7 (0.95–3.0)
major depression

Jia et al., 2006 [11] USA5825
males 98%
Patients with stroke diagnosis between October 2000 and September 2001 from a cohort of veterans, who survived 60 days or more after stroke, and with an index length of stay less than 365 daysDepression (primary or secondary diagnosis) according to ICD-9 codes and antidepressant medication dispensing within 12 months of the index stroke12 monthsCrude death rate:
11.0% versus 12.0%
depression versus no depression

Jorge et al., 2003
Patients between ages 25 and 89 years with acute stroke within the previous 6 months, between June 1991
and June 1997 and from double-blind, placebo-controlled trial
DSM-IV depression due to stroke, with “major depressive-like episode” or “minor depressive disorder,” according to the Present State Examination and Hamilton Depression Rating Scale9 yearsPrevalence of mortality:
25/56 (45%) versus 25/48 (52%)
depression versus no depression

Kemper et al., 2011 [13]Germany977
males 71%
Patients aged 50 years and older with first ischemic stroke in 2005, without previous aphasia, dementia, depression, or nursing care dependency Diagnosis of depression within the year after stroke, according to ICD-10 codes12 months after strokeAdjusted OR:
0.91 (0.55–1.52)
depression versus no depression

Morris et al., 1993a [14]Australia84
males 54%
Patients with stroke undergoing rehabilitation consecutively enrolled from 1986 to 1987 examined approximately two months after stroke (mean 7.6 weeks)DSM-III major depression approximately 2 weeks after stroke according to Composite International Diagnostic Interview (CIDI) and Montgomery and Asberg Depression Rating Scale
15 months after the initial evaluation (mean 59 weeks)Prevalence of mortality:
3/13 (23%) versus 1/48 (2%)
major depression versus no depression

Morris et al., 1993b [15]USA91
males: 59%
Patients consecutively admitted to a university hospital stroke unit between 1979 and 1981 with either thromboembolic cerebral infarction or intracerebral hemorrhageDSM-III major depression 1–3 weeks after stroke according to Present State Examination and Hamilton Depression Rating Scale 10 yearsPrevalence of mortality:
26/37 (70%) versus 22/54 (41%)
major depression versus no depression

Naess et al., 2010 [16]
376 returning questionnaire
males 60%
Patients with acute stroke consecutively admitted to the Stroke Unit, Haukeland University Hospital, Norway, from February 2006 to November 2008
Hospital Anxiety and Depression Scale (HADS-D) ≥ 11 (at least 6 months after stroke)
Mean followup: 382 days (range 185–756)
HR: 4.4 ( )
depression versus no depression

Paolucci et al., 2006 [17]Italy1064
males 60%
Patients with ischemic or hemorrhagic stroke (first or subsequent event) confirmed by neuroimaging (CT or MRI), consecutively admitted to one of the study centers between June 2000 and July 2001 (DESTRO study)Depression within the first 9 months after the stroke according to a Beck Depression Inventory (BDI) ≥ 102 yearsPrevalence of mortality:
5.48 % versus 4.85%
depression versus no depression

Ried et al., 2011 [18]USA790
males 98%
Patients with a stroke diagnosis between July 2000 and September 2001, from a cohort of veterans Major depressive disorder or depressive disorder NOS according to ICD-9 codes during the 12 months after stroke7-year follow-up period (maximum follow-up time: 2465 days)HR: 1.28 (0.96 to 1.71)
depression versus no depression

Willey et al., 2010 [19]USA340
males 42%
Patients with first-ever ischemic stroke between July 1993 and July 1997, aged >39 years (data deriving from the Northern Manhattan Stroke Study (NOMASS))First question on the Hamilton Depression
Rating Scale regarding their mood in the week after the onset of the stroke (assessment within 30 days of their stroke)
5 years from initial strokeAdjusted HR: 1.15 (0.76–1.75)
depression versus no depression

Williams et al., 2004 [20]USA51119
males 98%
Patients with a first ischemic stroke from a cohort of veterans who survived beyond 30 days afterward, from October 1990 to September 1998Diagnosis of depression in the first 3 years after stroke according to ICD-9 codes3 years after strokeAdjusted HR: 1.13 (1.06–1.21)
depression versus no depression