Resilience is associated with post-stoke depression in Chinese stroke survivors: A longitudinal study

Optimal strategies for prevention and treatment for post-stroke depression (PSD) remain unclear and a greater understanding of effect of resilience on PSD is promising. The aim was to examine the association between baseline resilience and depression at 1, 3, and 6 months after discharge, which contributes to early detection and management of PSD.

A total of 217 ischemic stroke survivors were recruited in two tertiary hospitals in Shanghai, China from February 2017 to January 2018. The Chinese version of Connor-Davidson Resilience Scale (CD-RISC) was used to assess resilience at acute hospitalization. Hospital Anxiety and Depression Scale (HADS) was employed to ascertain baseline anxiety, baseline depression, and post-discharge depression. Social-demographic and disease-related information were obtained from participants' self-report and medical records. Logistic regression analysis was used to determine which factors were independently associated with PSD.

The prevalence of depression at baseline was 21.2% and at 1, 3, and 6 months after discharge was 34.4%, 33.2%, and 29.2%, respectively. Logistics regression analyses indicated that resilience may independently predict PSD at 1 month (OR: 0.22, 95%CI: 0.097, 0.518), 3 months (OR:0.302, 95%CI: 0.151, 0.607), and 6 months (OR: 0.03, 95%CI: 0.006, 0.153) after controlling for social-demographics, disease-related characteristics, baseline anxiety, and baseline depression.

Non-multicenter survey and mild stroke severity may affect the generalization of these findings. Moreover, response bias should be acknowledged because some participants were read questionnaires out aloud.

Resilience is independently associated with PSD at different timepoints. Our findings reveal the important role of resilience as a protective factor against PSD.