Abstract
ObjectivesTo investigate the prevalence of post-stroke depression (PSD), its associated factors and impact on quality of life (QoL) among outpatients in a Nigerian hospital.MethodsThis cross-sectional study was carried out among 140 adults made up of 70 stroke survivors and matched controls with stable hypertension. Participants were administered questionnaires to profile their socio-demographic and clinical characteristics. Subsequently, they were assessed with the modified mini-mental state examination (MMSE), modified Rankin Scale (mRS), schedule for clinical assessment in neuropsychiatry (SCAN) and World Health Organization Quality of Life-BREF (WHOQoL-BREF).ResultsThe mean ages (± s.d.) of stroke survivors and controls were 57.43 (± 9.67) years and 57.33 (± 9.33) years, respectively. Majority of stroke survivors (n = 55 [78.6%]) had infarctive stroke, and 37 (52.9%) had right hemispheric lesion. Sixteen (22.9%) stroke survivors had PSD, with moderate to severe depression (F32.1) being the most prevalent, while none of the controls was clinically depressed. PSD correlated positively with monthly health bill above 10 000 naira ($61), significant post-stroke disability and poorer scores on all QoL domains (p < 0.05).ConclusionDepression was 20-fold prevalent in stroke survivors compared to controls with stable hypertension, and sevenfold the life-time prevalence reported among adult general population in Nigeria. Furthermore, increased health care bills per month, significant post-stroke disability and poorer QoL indicated survivors more likely to have depression. Findings in this study support the need to pay closer attention to psychosocial needs of stroke survivors to improve well-being. Future longitudinal study on psychosocial burden of stroke is warranted.
Highlights
Stroke is a leading cause of death and neurological disability that imposes heavy burden on families.[1]
The developing countries are worst affected as the World Health Organization (WHO) estimate suggested a sevenfold increase in disability-adjusted life years attributable to stroke in low- and middle-income regions compared to high-income regions.[3]
A total of 140 respondents took part in the study. This consisted of 70 stroke survivors and 70 stable patients with hypertension
Summary
Stroke is a leading cause of death and neurological disability that imposes heavy burden on families.[1]. Mental health problems post stroke can result from direct brain damage or because of maladaptive reactions to stroke sequelae. In any of the scenarios, interaction between personality makeup and adverse life situations often influences how survivors adjust to disability and in turn impact the rehabilitation process.[6] The common mental health morbidities post stroke include anxiety, depression, personality changes and psychotic disorders among others.[7,8] Depressive reactions are frequent among stroke survivors, as they deal with the abrupt and ‘novel’ experience of living with stroke that is often frightening and ill understood.[9] More often, survivors are unable to evaluate their situation objectively, which may lead to projection of blame outwardly or towards self.[9] In the acute phase of stroke, depression has been attributed to survivor’s cognitive interpretation of physical disabilities, enforced dependency on others and uncertainty about recovery as well as prognosis.[6] On the contrary, long-term risk factors for post-stroke depression (PSD) include job status, financial insecurity and permanent loss of independence among others.[6] http://www.sajpsychiatry.org
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
