Burden of Post-Stroke Depression and Associated Risk Factors: A Cross-Sectional Analysis
Keywords:
post-stroke depression; stroke severity; risk factors; neuropsychiatric complications; cerebrovascular diseaseAbstract
Background: Depression is one of the most prevalent and debilitating neuropsychiatric sequelae of stroke; its prevalence and risk factors remain variable in different populations, with different assessment tools and in different healthcare environments. The aim of this study is to estimate the prevalence of post-stroke depression (PSD) and determine demographic and clinical risk factors for PSD in a sample of stroke survivors, and to guide more specific, evidence-based screening for PSD in routine post-stroke care.
Participants: 150 stroke survivors (mean age 61.5 ± 15.4 years; 46.0% female) were evaluated 1–24 months after stroke onset. Each participant's depression status, stroke type (ischemic/hemorrhagic), stroke severity (mild/moderate/severe), and comorbid hypertension and diabetes mellitus were documented. Chi-square analysis was used to test bivariate associations, and independent predictors of PSD were identified using multivariable logistic regression with bootstrap-derived 95% confidence intervals (CIs) to provide robust estimates of effect-sizes for the sample size.
Results: The overall prevalence of PSD was seen as 40.7% (61/150). PSD was significantly more common among women than men (50.7% vs 32.1%, χ²=4.61, p=0.032) and among patients with severe stroke (77.1%) compared with those with moderate (17.3%) or mild (30.0%) stroke (χ²=40.50, p<0.001). Severe stroke (adjusted OR 8.11, 95% CI 3.56–32.35) and female sex (adjusted OR 2.31, 95% CI 1.05–6.45) were still independent risk factors for PSD, and stroke type, hypertension, diabetes, age, and time since stroke were not (all p>0.05).
Conclusions: Depression was present in 2/5 of stroke survivors in this group and stroke severity and female sex were the most significant independent risk factors. The results indicate that there is a need for routine, severity-stratified screening of depression, especially in women and patients with severe neurological impairment.
