The association between serum ferritin levels and post-stroke depression

Background: Post-stroke depression (PSD) is a common neuropsychiatric affective disorder occurring after stroke. Elevated serum ferritin levels have been reported to contribute to depression. Our aim was to determine whether there is a relationship between serum ferritin levels and PSD. Methods: 196 ischemic stroke patients were consecutively recruited within the first 24 h of stroke onset and were followed up for 2 months. Serum ferritin levels were assayed by electrochemiluminescence immunoassay at hospital admission. Clinical depression was diagnosed according to DSM-IV criteria and a HAMD -17 score of >= 7. Meanwhile, 100 normal control subjects were also recruited. Results: We found that 56 stroke patients (28.6%) were diagnosed with PSD at two months. There was a significant intergroup difference in serum ferritin levels within 24 h after admission (F=25.044, P<0.001). Serum ferritin levels were significantly higher at admission in PSD patients than in non-PSD patients and normal controls. There was a positive correlation between serum ferritin levels and hs-CRP at admission in PSD patients (r=0.129, P=0.042). In multivariate analyses, serum levels of ferritin >= 130.15 mu g/L were independently associated with PSD at two months [odds ratio OR=5.388, 95% CI:1.725-16.829; P=0.004] after adjusting for all possible variables. Limitations: We excluded patients with severe aphasia and with serious conditions. In addition, the information for dietary intake was not recorded, which may influence body iron stores. Conclusion: Our findings show that elevated serum ferritin levels at admission are associated with PSD and may predict its development at 2 months post-stroke. (C) 2015 Elsevier B.V. All rights reserved.