Stroke Survivors Have Almost Three Times Higher Risk of Depression: A Systematic Review and Meta-Analysis

Background: Post-stroke depression (PSD) is one of the most frequent and important complications following stroke that adversely affects conditions such as functional recovery and the patient's quality of life. Meanwhile, the prevalence proportion of PSD has been widely documented, ranging from 20 to 60%; the relationship between stroke and the manifestation of PSD, quantified with the odds ratio (OR), has been less explored. The primary aim of this meta-analysis is to determine the prevalence OR of suffering depression in stroke survivors. The prevalence proportion of PSD was also analyzed as a secondary aim. Methods: A pre-registered meta-analysis designed based on PRISMA guidelines with searches from inception to 23 September 2024 was carried out on PubMed, Web of Science, and SCOPUS databases. Studies reporting the prevalence OR associated with PSD manifestation were eligible for inclusion to achieve the primary aim. Twenty-six comparative studies, including a total population of 947,853 people, met the inclusion criteria. PSD prevalence proportion was extracted from 245 articles, including 493,681 stroke patients. Quality assessments were performed using the Newcastle-Ottawa Scale (NOS). Data were meta-analyzed using a random-effects model. Results: Compared with the control population, stroke survivors had higher odds of developing PSD (OR: 2.71; 95% CI: [2.29-3.22]). Prevalence of PSD was 34.46 ± 16.48. Conclusions: Stroke survivors have almost 3 times higher probability of suffering depression after stroke than the general population, and almost one third of stroke patients will suffer PSD.