Abstract
Depressive symptoms are common in stroke survivors, and they are associated with poor outcomes. Therefore, this study aimed to investigate the depressive symptoms in stroke survivors and the risk factors for depressive symptoms in stroke survivors. We included 33,991 participants who were 19 years or older and had completed a questionnaire about the history of stroke from the Korea National Health and Nutrition Examination Survey (KNHANES) IV–VII (from 2007 to 2018). The mean Patient Health Questionnaire-9 score and the prevalence of major depression, depressive symptoms, antidepressant treatment, suicidal ideation, and suicide attempts were significantly higher in stroke survivors than in non-stroke participants (4.4 vs. 2.6, 16.2% vs. 5.3%, 24.7% vs. 9.3%, 3.8% vs. 1.4%, 21.7% vs. 4.8%, and 2.5% vs. 0.6%, respectively, all p < 0.001). Complex sample multivariate logistic regression analysis revealed that the female sex, unemployment, a low education level, a low family income, and activity limitations were independent risk factors for depressive symptoms in stroke survivors. Activity limitations showed the highest odds ratio among the independent factors, and its causes were further analyzed. The most common causes of activity limitations were stroke sequelae and musculoskeletal problems. To reduce depressive symptoms in stroke survivors, attention needs to be paid to minimizing stroke sequelae and musculoskeletal problems along with regular screening for depressive symptoms.
Highlights
Published: 2 August 2021Stroke survivors have an increased incidence of neuropsychiatric disorders, such as depression and generalized anxiety disorder [1]
Participants who answered “Yes” to the question of “Have you ever been diagnosed with stroke by a doctor?” were defined as stroke survivors in this study
The stroke survivors were significantly older than non-stroke participants (p < 0.001)
Summary
Published: 2 August 2021Stroke survivors have an increased incidence of neuropsychiatric disorders, such as depression and generalized anxiety disorder [1]. Stroke survivors’ depressive symptoms are negatively associated with survival, functional outcome, and quality of life [5,6]. Many factors have been suggested as risk factors for depression in stroke patients, it is still unclear which factors are associated with depression [7,8,9,10]. Conflicting results have been reported on the relationship between depression and stroke characteristics, such as lesion location and lesion size [11,12]. A recent meta-analysis study reported that lesion location might be a significant risk factor, but not lesion laterality or type of stroke. In addition to stroke characteristics, demographics and socioeconomic characteristics may be significant risk factors for depression in stroke survivors [13]. Consistent results have not always been reported for these
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