Prevalence and predictors of new onset depression in the acute phase of stroke

Introduction: Post-stroke depression (PSD) is known to be associated with poor functional outcome and high mortality. There is limited data on the prevalence and associated factors of depression in the acute phase after stroke. Objectives: To determine the prevalence of PSD in the acute phase and its correlates among patients with stroke in a tertiary care hospital in Sri Lanka. 

Method: A cross sectional descriptive study was conducted among patients with stroke admitted to the stroke unit of a tertiary care hospital in Sri Lanka over a 3-year period. Demographic and clinical information was obtained using an interviewer administered questionnaire. Depression was diagnosed using the ICD-10 criteria. Group comparisons were performed using Pearson's Chi-square test and Mann-Whitney U test Multiple logistic regression was used to identify factors associated with PSD. 

Results: Of 374 patients, 106 patients experienced moderate to severe PSD, with a prevalence of 28.3 % (95 % CI: 23.8 %–32.9 %). Of them, 54.7 % were females, 49 % were above the age of 60 years, and 79.9 % had ischemic strokes. Female gender (OR-2.77, 95 % CI: 1.46–5.07, P = 0.002), a longer duration of hypertension (OR-1.31, 95 % CI: 1.01–1.721, P = 0.004), strokes involving the temporal lobe (OR-7.25, 95 % CI: 2.81–20.25, P < 0.001) and post-stroke functional disability (OR- O.98, 95 % CI:0.97−0.99, P = 0.001) were associated with PSD on multivariate analysis. 

Conclusion: More than one fourth of the patients suffered from PSD in the acute phase of stroke. Female gender, longer history of hypertension, physical dependence and temporal lobe strokes were predictive of PSD.