Prevalence and associated factors of post-stroke depression among stroke survivors during the early rehabilitation period: a cross-sectional study

Background: Post-stroke depression (PSD) is the commonest psychiatric morbidity observed among stroke survivors and it has a significant negative impact on the rehabilitation process.

Aims: This study aimed to identify the prevalence of PSD, its associated factors, and the relationship between the severity of depression and functional impairment among stroke survivors during the first six months of rehabilitation.

Methods: A descriptive cross-sectional study using a convenient sampling method was carried out at the Rheumatology and Rehabilitation Hospital (RRH), Ragama, among patients during the first six months following stroke. PSD was screened with Sinhala and Tamil translations of the Patient Health Questionnaire-9 (PHQ-9) and functional ability was measured using the validated Lawton Instrumental Activities of Daily Living (IADL) scale. Pearson’s correlation coefficient, ANOVA, independent-sample t-test, and binary logistic regression were used for statistical analysis.

Results: Among 70 participants of ages 33-79 years (mean ± SD: 56.3 ± 11.31) depressive symptoms were observed among 74.3%. A negative correlation (- 0.428) was observed between PSD and functional ability. There was a statistically significant association (p<0.05) between PSD and female gender, stroke affecting the dominant side of the body and previous history of stroke. A low score on IADL (OR = 0.506, 95% CI: 0.274 - 0.936) and stroke affecting the dominant side of the body (OR = 0.013, 95% CI: 0.01 - 0.270) was observed to be significant risk factors to be screened positive for major depression as per the PHQ-9.

Conclusion: We detected a high prevalence of PSD among the participants as per the PHQ 9 and a negative correlation between PSD and functional ability. Screening for depression and appropriate management of PSD in stroke survivors should be practised during the early rehabilitation period.