Risk factors of post-stroke depression among stroke survivors in Lagos, Nigeria

Abstract

Objective: Stroke is an important neurological problem and a leading cause of death in clinical practice. Among survivors, over half have significant disabilities; and/or psychiatric complications most especially Post-stroke depression (PSD). The study aimed to establish prevalence and risk factors for post stroke depression. Method: A prospective study carried out among selected stroke survivors in Lagos University Teaching Hospital (LUTH). Subjects included those who satisfied the WHO definition of stroke. The necessary socio-demographic data was obtained from each subject; the Depression Anxiety Stress Scale-21 (DASS-21) and Modified Motor Assessment Scale (MMAS) were administered. Risk factors of PSD studied were gender, laterality of stroke, post stroke functional impairment and post stroke duration before clinical presentation. Results: A total of 51 stroke survivors were studied, made up of 31 (60.8%) males and 20 (39.2%) females. The mean age was 52.5±5.9 years; and age range of 40-64 years. From assessment with the depression subscale of DASS-21, 38 (74.5%) of the subjects were normal and the rest 13 (25.5%) had depression. Risk factors found to be statistically significant for PSD in the study included: gender (X2=10.3 at p=0.001*) and stroke laterality (X2=6.1 at p=0.013*). However, there were no statistically significant differences for mean post-stroke duration before clinical presentation and PSD ("t"=3.5 and p= 0.073); and post-stroke disability as shown by mean MMAS scores and PSD ("t"=7.6 and p= 0.084). Conclusion: Depression was found to be an important complication among stroke survivors in our study. Important risk factors found for PSD included gender and laterality. The findings emphasized a need for appropriate health facilities and for stroke survivors to present early for treatment to attenuate stroke complications.