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Thursday, February 19, 2009

Post-stroke depression: cultural differences

I went to a session far too early this morning on cross-cultural differences in post-stroke emotional distress. It focused mainly on post-stroke depression in both patients and caregivers, though there was some mention of post-stroke anger as well. The upshot seemed to be that there isn't a great deal of research in this area; most of the info about cultural differences comes from the general depression research, or research on depression related to diseases other than stroke. Some interesting tidbits:

--Research on depression in caregivers of patients with dementia suggests that Asian and Hispanic American caregivers are more prone to depression than whites, while African American caregivers are less prone to it. One study on stroke patient caregivers found African American caregivers had a 3.7 times lower risk for depression than whites.

--There is some evidence that genetic differences in ethnicities may affect both the likelihood of getting depression and response to treatment, but it's complicated. Several genes seem to be involved, such that a mutation in any single gene accounts for only a small portion of the disease risk.

--There is some evidence that while somatic symptoms of depression may be the same between cultures, cognitive symptoms may be different. For example, Westerners are more likely to report psychological symptoms than the Chinese. Treatment response appears to be the same among different cultures, however.

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