{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:34:38Z","timestamp":1793392478688,"version":"4.5.0"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Stroke is a significant global health concern, and numerous studies have established a link between depression and an increased risk of stroke. While many investigations explore this link, some overlook its long-term effects. Depression may elevate stroke risk through physiological pathways involving nervous system changes and inflammation. This systematic review and meta-analysis aimed to assess the association between depression and stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>We conducted a comprehensive search of electronic databases (PubMed, Embase, Scopus, and PsycINFO) from inception to 9 April 2023, following the Preferred Reporting Items for Systemic Review and Meta-analysis (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. We included all articles assessing the association between different stroke types and depression, excluding post-stroke depression. Two investigators independently extracted data and assessed quality using the Newcastle\u2013Ottawa Scale and Cochrane Risk of Bias tool, utilizing a random-effects model for data synthesis. The primary outcome was the association of depression with stroke, with a secondary focus on the association of antidepressants with stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The initial search yielded 10,091 articles, and 44 studies were included in the meta-analysis. The pooled analysis revealed a significant association between depression and stroke risk, with an overall hazard ratio of 1.41 (95% CI 1.32, 1.50; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.00001), indicating a moderately positive effect size. Subgroup analyses showed consistent associations with ischemic stroke (HR\u2009=\u20091.30, 95% CI 1.13, 1.50; <jats:italic>p<\/jats:italic>\u2009=\u20090.007), fatal stroke (HR\u2009=\u20091.39, 95% CI 1.24, 1.55; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.000001), and hemorrhagic stroke (HR\u2009=\u20091.33, 95% CI 1.01, 1.76; <jats:italic>p<\/jats:italic>\u2009=\u20090.04). The use of antidepressants was associated with an elevated risk of stroke (HR\u2009=\u20091.28, 95% CI 1.05, 1.55; <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and relevance<\/jats:title><jats:p>This meta-analysis indicates that depression moderately raises the risk of stroke. Given the severe consequences of stroke in individuals with depression, early detection and intervention should be prioritized to prevent it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p>Prospero (CRD42023472136).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1331300","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T04:33:46Z","timestamp":1714019626000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Association between depression and stroke risk in adults: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Farheen","family":"Ashraf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Saqlain","family":"Mustafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ashir","family":"Shafique","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Haseeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Mussarat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Noorani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burhanuddin","family":"Sohail Rangwala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah","family":"Kashif Rasool","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Arham","family":"Siddiq","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Iqbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"634","DOI":"10.2471\/BLT.16.181636","article-title":"Stroke: a global response is needed","volume":"94","author":"Johnson","year":"2016","journal-title":"Bull World Health Organ"},{"key":"ref2","first-page":"50","article-title":"The WHO world health report 2001 new understanding--new hope","volume":"39","author":"Levav","year":"2002","journal-title":"Isr J Psychiatry Relat Sci"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1161\/STROKEAHA.111.630871","article-title":"Depression and risk of stroke: a meta-analysis of prospective 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