Depression after stroke at 12-month follow-up: a multicenter study

ABSTRACT

Purpose: To study the prevalence of depression at 12 months after stroke and to analyze factors associated with depression.

Methods: This prospective cross-sectional study was conducted among nine tertiary hospitals in Thailand. Stroke patients from the Thai Stroke Rehabilitation Registry who were admitted in inpatient rehabilitation wards were recruited for evaluation at the 12-month follow-up time point. Hospital Anxiety and Depression Scale (HADS) was used to evaluate depression in stroke. A score of ≥11 was considered as having depression. Univariate and multivariate analysis was used to investigate factors related with depression in stroke.

Results: Two hundred stroke patients with a mean age of 62.1±12.5 years were recruited. Approximately 60% were male. The number of stroke patients with depression at the 12-month follow-up was 42 (21.0%, 95%CI 15.9%–27.2%). Mean HADS score at 12-month follow-up was not significantly different from those at discharge. However, 28 (16.5%) stroke patients who did not have depression at discharge developed depression during the 12-month period. From multivariate analysis, complications and urinary incontinence were found to be significantly associated with depression after stroke with adjusted odds ratio of 3.65 (95%CI 1.11–12.06) and 4.82 (95%CI 1.74–13.38), respectively.

Conclusion: Depression is a common complication after stroke. This study found one-fifth of stroke survivors developed depression at the 12-month follow-up. Complications at discharge and urinary incontinence were significantly correlated with depression in multivariate analysis. Further study concerning interventions in decreasing depression should be performed in order to improve the quality of life of those stroke patients.

KEYWORDS:

• Stroke
• depression
• rehabilitation
• HADS

Acknowledgements

The authors gratefully acknowledge Dr. Apichana Kovindha, Dr. Pornpimon Massakulpan, Dr. Krisna Piravej, Dr. Sumalee Suethanapornkul, Dr. Piyapat Dajpratham, Dr. Nuttaset Manimmanakorn, Dr. Wutichai Permsirivanich, Dr. Yingsumal Archongka, and Dr. Patcharawimol Srisa-an Kuptniratsaikul for data contributions from their respective medical centers. The authors also thank Miss Julaporn Poolium for assistance with data analysis. Finally, we deeply appreciate the stroke patients and caregivers that generously agreed to participate in this study.

This study was supported by grants from the National Research Council of Thailand and the Clinical Research Collaboration Network. The aforementioned funding agencies had no influence on the interpretation of data or the final conclusions drawn.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

National Research Council of Thailand and the Clinical Research Collaboration Network.