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Ruth Kohen, MD; Kevin C. Cain, PhD; Pamela H. Mitchell, PhD; Kyra Becker, MD; Ann Buzaitis, MN, ARNP; Steven P. Millard, PhD; Grace P. Navaja, BS; Linda Teri, PhD; David Tirschwell, MD, MSc; Richard Veith, MD

Arch Gen Psychiatry. 2008;65(11):1296-1302.

Context  Polymorphisms of the serotonin transporter gene (SERT) have been associated with mental illness. In people with long-term medical conditions, variants of the 5-HTTLPR and STin2 VNTR polymorphisms of SERT have been shown to confer a heightened vulnerability to comorbid depression.

Objective  To determine whether the 5-HTTLPR, STin2 VNTR, and rs25531 polymorphisms of SERT are associated with poststroke depression (PSD) in stroke survivors.

Design  A case-control study in which stroke survivors were screened for depressive symptoms and assigned to either a depressed group or a nondepressed group.

Setting  Outpatient clinic.

Participants  Seventy-five stroke survivors with PSD and 75 nondepressed stroke survivors.

Interventions  Blood or saliva samples were collected from each participant for DNA extraction and genotyping.

Main Outcome Measures  The associations between the 5-HTTLPR, STin2 VNTR, and rs25531 polymorphisms and PSD.

Results  Individuals with the 5-HTTLPR s/s genotype had 3-fold higher odds of PSD compared with l/l or l/xl genotype carriers (odds ratio, 3.1; 95% confidence interval, 1.2-8.3). Participants with the STin2 9/12 or 12/12 genotype had 4-fold higher odds of PSD compared with STin2 10/10 genotype carriers (odds ratio, 4.1; 95% confidence interval, 1.2-13.6). An association of rs25531 with PSD was not shown.

Conclusions  The 5-HTTLPR and the STin2 VNTR, but not the rs25531, polymorphisms of SERT are associated with PSD in stroke survivors. This gives further evidence of a role of SERT polymorphisms in mediating resilience to biopsychosocial stress.

Author Affiliations: Departments of Psychiatry and Behavioral Sciences (Drs Kohen and Veith and Ms Navaja), Biostatistics (Dr Cain), Biobehavioral Nursing and Health Systems (Dr Mitchell and Ms Buzaitis), Neurology (Drs Becker and Tirschwell), and Psychosocial and Community Health (Dr Teri) and Office for Nursing Research (Dr Cain), University of Washington, Seattle; and Department of Veterans Affairs Puget Sound Health Care System, Seattle (Drs Kohen and Millard and Ms Navaja).

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