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Prevalence and Associated Factors of Depression in Patients with Ischaemic Stroke: A Cross-Sectional Study
Yifan Li1, Wei Qin1, Yitong Chen2
1Department of Integrative Traditional Chinese and Western Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People's Republic of China.
Insights
Depression is prevalent after ischemic stroke, influenced by factors like hypertension, diabetes, and stroke severity. Neurological deficits and daily living abilities, measured by NIHSS and ADL scores, are key predictors of depression risk.
Area of Science:
- Neurology
- Psychiatry
- Public Health
Background:
- Ischemic stroke is a leading cause of disability worldwide.
- Depression is a common and serious complication following stroke.
- Understanding depression's prevalence and predictors is crucial for patient care.
Purpose of the Study:
- To determine the prevalence and severity of depression in ischemic stroke patients.
- To identify factors associated with depression in this population.
Main Methods:
- A cross-sectional study involving 499 ischemic stroke patients.
- Assessed depression using the Hamilton Depression Rating Scale (HAMD).
- Utilized logistic regression and ROC curves to identify predictors.
Main Results:
- 61.1% had mild and 38.9% had moderate depression.
- Hypertension, diabetes, lower education, left-sided stroke, lower ADL, and higher NIHSS scores predicted depression.
- NIHSS and ADL scores showed strong predictive value (AUC 0.797 and 0.741, respectively).
Conclusions:
- Depression is highly prevalent in ischemic stroke survivors.
- Vascular risk factors, education, stroke characteristics, and functional status significantly influence depression.
- NIHSS and ADL scores are valuable tools for predicting depression risk.
Objective:
To investigate the prevalence and severity of depression in patients with ischaemic stroke and identify its associated factors using a cross-sectional design over a 6-month period.
Methods:
This cross-sectional study included 499 patients with ischaemic stroke who met the diagnostic and inclusion criteria. Depression levels were assessed using the Hamilton Depression Rating Scale (HAMD). Data collection included demographic variables, clinical data and self-reported measures. Neurological deficits were assessed using the National Institutes of Health Stroke Scale (NIHSS), whereas activities of daily living (ADL) were evaluated using the ADL scale. Chi-squared tests and t-tests were used to compare the mild and moderate depression groups. Multiple logistic regression identified independent predictors of depression. The predictive effectiveness of risk factors was evaluated using receiver operating characteristic (ROC) curves.
Results:
Of the 499 patients, 305 (61.1%) had mild depression and 194 (38.9%) had moderate depression, with a mean HAMD score of 15.27 ± 6.43. Significant differences were observed between groups in hypertension (p < 0.001), diabetes mellitus (p < 0.001), education level (p < 0.001), stroke location (p = 0.037), ADL score (p < 0.001) and NIHSS score (p < 0.001). Logistic regression identified hypertension (odds ratio [OR] = 1.963), diabetes mellitus (OR = 4.126), lower education level (OR = 1.460), left-sided stroke (OR = 1.690), lower ADL scores (OR = 0.718) and higher NIHSS scores (OR = 1.213) as independent predictors of depression. The ROC analysis showed that NIHSS (area under the curve [AUC] = 0.797) and ADL (AUC = 0.741) scores were the most effective predictors.
Conclusion:
Depression is common among patients with ischaemic stroke and is substantially influenced by vascular risk factors, education level, stroke location, daily living abilities and neurological deficits. The NIHSS and ADL scores demonstrated strong predictive value in identifying patients at risk of depression.
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