Stroke Depression Research Articles

Brain Health Outcomes in Sexual and Gender Minority Groups: Results From the All of Us Research Program.

Sexual and gender minority (SGM) groups have been historically underrepresented in neurologic research, and their brain health disparities are unknown. We aim to evaluate whether SGM persons are at higher risk of adverse brain health outcomes compared with cisgender straight (non-SGM) individuals. We conducted a cross-sectional study in the All of Us Research Program, a US population-based study, including all participants with information on gender identity and sexual orientation. We used baseline questionnaires to identify sexual minority (lesbian, gay, bisexual, diverse sexual orientation; nonstraight sexual orientation) and gender minority (gender diverse and transgender; gender identity different from sex assigned at birth) participants. The primary outcome was a composite of stroke, dementia, and late-life depression, assessed using electronic health record data and self-report. Secondarily, we evaluated each disease separately. Furthermore, we evaluated all subgroups of gender and sexual minorities stratified by sex assigned at birth. We used multivariable logistic regression (adjusted for age, sex assigned at birth, race/ethnicity, cardiovascular risk factors, other relevant comorbidities, and neighborhood deprivation index) to assess the relationship between SGM groups and the outcomes. Of 413,457 US adults enrolled between May 31, 2017, and June 30, 2022, we included 393,041 participants with available information on sexual orientation and gender identity (mean age 51 [SD 17] years), of whom 39,632 (10%) belonged to SGM groups. Of them, 38,528 (97%) belonged to a sexual minority and 4,431 (11%) to a gender minority. Compared with non-SGM, SGM persons had 15% higher odds of the brain health composite outcome (odds ratio [OR] 1.15, 95% CI 1.08-1.22). In secondary analyses, these results persisted across sexual and gender minorities separately (all 95% CIs > 1). Assessing individual diseases, all SGM groups had higher odds of dementia (SGM vs non-SGM: OR 1.14, 95% CI 1.00-1.29) and late-life depression (SGM vs non-SGM: OR 1.27, 95% CI 1.17-1.38) and transgender women had higher odds of stroke (OR 1.68, 95% CI 1.04-2.70). In a large US population study, SGM persons had higher odds of adverse brain health outcomes. Further research should explore structural causes of inequity to advance inclusive and diverse neurologic care.

The predictive validity of a Brain Care Score for late-life depression and a composite outcome of dementia, stroke, and late-life depression: data from the UK Biobank cohort.

The 21-point Brain Care Score (BCS) is a novel tool designed to motivate individuals and care providers to take action to reduce the risk of stroke and dementia by encouraging lifestyle changes. Given that late-life depression is increasingly recognized to share risk factors with stroke and dementia, and is an important clinical endpoint for brain health, we tested the hypothesis that a higher BCS is associated with a reduced incidence of future depression. Additionally, we examined its association with a brain health composite outcome comprising stroke, dementia, and late-life depression. The BCS was derived from the United Kingdom Biobank baseline evaluation in participants with complete data on BCS items. Associations of BCS with the risk of subsequent incident late-life depression and the composite brain health outcome were estimated using multivariable Cox proportional hazard models. These models were adjusted for age at baseline and sex assigned at birth. A total of 363,323 participants were included in this analysis, with a median BCS at baseline of 12 (IQR: 11-14). There were 6,628 incident cases of late-life depression during a median follow-up period of 13 years. Each five-point increase in baseline BCS was associated with a 33% lower risk of incident late-life depression (95% CI: 29%-36%) and a 27% lower risk of the incident composite outcome (95% CI: 24%-30%). These data further demonstrate the shared risk factors across depression, dementia, and stroke. The findings suggest that a higher BCS, indicative of healthier lifestyle choices, is significantly associated with a lower incidence of late-life depression and a composite brain health outcome. Additional validation of the BCS is warranted to assess the weighting of its components, its motivational aspects, and its acceptability and adaptability in routine clinical care worldwide.

Bidirectional relationship between epigenetic age and brain health events.

Chronological age offers an imperfect estimate of the molecular changes that occur with aging. Epigenetic age, which is derived from DNA methylation data, provides a more nuanced representation of aging-related biological processes. This study examines the bidirectional relationship between epigenetic age and the occurrence of brain health events (stroke, dementia, and late-life depression). Using data from the Health and Retirement Study, we analyzed blood samples from over 4,000 participants to determine how epigenetic age relates to past and future brain health events. Study participants with a prior brain health event prior to blood collection were 4% epigenetically older (beta 0.04, SE 0.01), suggesting that these conditions are associated with faster aging than that captured by chronological age. Furthermore, a one standard deviation increase in epigenetic age was associated with 70% higher odds of experiencing a brain health event in the next four years after blood collection (OR 1.70, 95%CI 1.16-2.50), indicating that epigenetic age is not just a consequence but also a predictor of poor brain health. Both results were replicated through Mendelian Randomization analyses, supporting their causal nature. Our findings support the utilization of epigenetic age as a useful biomarker to evaluate the role of interventions aimed at preventing and promoting recovery after a brain health event.

Research Progress in the Treatment of Post-stroke Depression with Traditional Chinese Medicine

In recent years, the incidence rate of stroke has increased year by year. Post stroke depression is one of its main complications, which seriously affects the recovery of physiological functions and quality of life of stroke patients. Traditional Chinese medicine has significant therapeutic effects in treating this disease. This article provides a classification and review of traditional Chinese medicine treatment methods for post-stroke depression, and looks forward to the current problems.

Exploring the potential molecular intersection of stroke and major depression disorder

Stroke and major depression disorder are common neurological diseases, and a large number of clinical studies have shown that there is a close relationship between the two diseases, but whether the two diseases are linked at the genetic level needs to be further explored. The purpose of this study was to explore the comorbidity mechanism of stroke and major depression by using bioinformatics technology and animal experiments. From the GEO database, we gathered transcriptome data of stroke and depression mice (GSE104036, GSE131712, GSE81672, and GSE146845) and identified comorbid gene set through edgR and WGCNA analyses. Further analysis revealed that these genes were enriched in pathways associated with cell death. Programmed cell death gene sets (PCDGs) are generated from genes related to apoptosis, necroptosis, pyroptosis and autophagy. The intersection of PCDGs and comorbid gene set resulted in two hub genes, Mlkl and Nlrp3. Single-cell sequencing analysis indicated that Mlkl and Nlrp3 are mainly influential on endothelial cells and microglia, suggesting that the impairment of these two cell types may be a factor in the relationship between stroke and major depression. This was experimentally confirmed by RT–PCR and immunofluorescence staining. Our research revealed that two specific genes, namely, Mlkl and Nlrp3, play crucial roles in the complex mechanism that links stroke and major depression. Additionally, we have predicted six possible therapeutic agents and the outcomes of docking simulations of target proteins and drug molecules.

Assessment of depressive symptoms among post stroke patients attending a Nigerian tertiary hospital

Background: Post Stroke Depression (PSD) occurs in a significant number of patients and constitutes an important complication of stroke, leading to greater disability as well as increased mortality. This study examined depressive symptoms among post stroke patients attending neurology clinic in a tertiary hospital in Northwest Nigeria. Methods: This cross-sectional study was carried out among 83 stroke survivors. Participants were administered socio-demographic, clinical characteristics pro-forma questionnaire and depression subscale of the Hospital and Anxiety Depressive Scale (HADS). Results: The 83 participants recruited for study had a mean age of 56.8 years (s.d. = 10.2) and 62.7 % were female. Majority (60.2%) had formal education, 83.1% were employed, and 73.5% were married. Overall, the prevalence of depressive symptoms was 34.9% while 2.4% were rated as having severe depressive symptoms. Unemployment, having disabilities and post stroke complications were significantly associated with depressive symptoms. Conclusion: The presence of depressive symptoms among stroke patients supports the need to consider routine screen for psychiatry morbidity among patients with medical condition that causes disabilities. Disability has been identified as the main predictor of depressive symptoms. In view of this, psychosocial evaluation and intervention should be integrated into clinical care of stroke patients for early detection of depressive symptoms.

The factors influencing the occurrence of post-ischemic stroke depression and its relationship with the burden score of cerebral small vessel disease.

This study explored the determinants of post-stroke depression (PSD) in ischemic stroke (AIS) patients and its association with the burden score of cerebral small vessel disease (CSVD). We analyzed 374 AIS patients treated between January 2020 and January 2022. Patients were categorized into 90 with PSD and 284 without PSD, enabling an investigation into PSD risk factors and the CSVD-PSD relationship. There was no significant difference in health factors between PSD and non-PSD patients (p>0.05). However, significant disparities were noted in age, gender, initial Barthel Index (BI), Mini-Mental State Examination (MMSE) score, plasma fibrinogen, homocysteine, red cell distribution width, National Institutes of Health Stroke Scale (NIHSS) score, and CSVD burden score (p<0.05). Regression analysis indicated that these variables were pivotal PSD predictors (OR>1, p<0.05). Surprisingly, a positive correlation with PSD occurrence was found for age, NIHSS score, plasma fibrinogen, homocysteine levels, red cell distribution width, CSVD burden score (r=0.565, 0.615, 0.482, 0.514, 0.572, 0.608, respectively; p<0.05). Meanwhile, the MMSE score and BI index were inversely related to PSD onset (r=-0.604, -0.590; p<0.05). The ROC curve analysis of the combination model based on MMSE, NIHSS and CSVD score revealed an AUC of 0.926 and Youden's index of 0.744. Age, MMSE score, BI index, NIHSS score, plasma fibrinogen concentration, homocysteine level, red blood cell distribution width, and CSVD burden score are all major influencing factors in the occurrence of PSD. The combination model based on MMSE, NIHSS, and CSVD scores presented a valuable approach to predicting PSD.

Post Stroke Depression: Relationship with Upper Limb Recovery, Activity and Participation

Post Stroke Depression: Relationship with Upper Limb Recovery, Activity and Participation

Systematic review: early detection of post stroke depression symptoms

The importance of early detection of early symptoms of post-stroke depression (PSD) is to prevent psychosocial problems in stroke patients. Post-stroke depression is an abnormal psychological symptom in someone who has suffered a stroke. PSD is a complication of stroke with a prevalence of 9-60% which is characterized by mood abnormalities, self-blame, sadness and depression. PSD can hinder the recovery of neurological function and daily activities of stroke patients, thus making the condition of stroke sufferers worse. The aim of the research is for early detection of PSD symptoms and PSD intervention. Method: systematic review using the literature search method with systematic reviews (PRISMA) as the standard for conducting systematic reviews. Article searches were carried out in electronic databases such as Science Direct, Pubmed and Proquest, Google Scholar using the keywords Depression, Diagnosis, Intervention and stroke. The criteria for selected articles are 1) published in 2019-2023 2) full text 3) articles in English and Indonesian. Articles were selected according to the criteria and a total of 6 articles out of 5312 articles were obtained with PRISMA. This research found that there are many types of instruments for early detection of post-stroke depression symptoms and appropriate intervention according to the level of depression. The high prevalence of PSD is due to the care giver not detecting early symptoms of depression, which worsens the condition of stroke sufferers. Most stroke patients experience severe depression. The researcher's suggestion is that there is a need for a program to provide education to stroke patients and their families in recognizing the early signs and symptoms of PSD, so that they can prevent the occurrence of depression in both clinical and community settings.

Abstract HUP2: Brain Health Outcomes in Sexual and Gender Minority Groups

Background: There is mounting evidence that sexual and gender minority (SGM) groups experience health disparities, but research on brain health status of this underrepresented group is limited. We evaluated whether SGM persons are at higher risk of adverse brain health outcomes compared to cisgender heterosexual (non-SGM) individuals. Methods: We conducted a cross-sectional study in the All of Us Research Program, a population study focused on health disparities enrolling 1 million Americans. We used baseline questionnaires to identify participants from sexual minorities (non-straight e.g., gay, lesbian, bisexual) and gender minorities (gender identity different from sex assigned at birth). We further divided gender minorities into gender diverse (e.g., non-binary) and transgender. The primary outcome was a composite of stroke, dementia, and late-life depression. In secondary analyses, we analyzed SGM subgroups and diseases separately. We used multivariate logistic regression to assess the link between SGM groups and brain health outcomes. Results: We included 393,041 participants (mean age 51, female sex at birth 62%), of whom 39,632 (10%) belonged to SGM groups. Of these, 4,431 (1%) belonged to a gender minority (2,212 [50%] gender diverse and 2,219 [50%] transgender) and 38,528 (10%) to a sexual minority. Full results are shown in the Figure. Compared to non-SGM, SGM individuals had 19% higher odds of the brain health composite outcome (OR 1.19, 95%CI 1.13-1.25). These results were consistent across all SGM subgroups (p&lt;0.05). When assessing individual diseases, all SGM groups had higher odds of late-life depression, all SGM except transgender persons had higher odds of dementia, and gender minority groups had higher odds of stroke. Conclusion: In a large US population study, SGM individuals had a higher rate of adverse brain health outcomes. Further research should explore the structural causes of inequity to advance inclusive and diverse neurological care.

Abstract 69: Epigenetic Age and Brain Health Events: Findings From the Health and Retirement Study

Introduction: It is increasingly recognized that chronological age provides an incomplete assessment of true biological age. Epigenetic clocks use DNA methylation data to estimate biological age more accurately. We hypothesize that brain health events (BHe) lead to epigenetic age acceleration and that, conversely, accelerated epigenetic age leads to higher risk of BHe. Methods: We conducted a 3-stage epigenetic study within the Health and Retirement Study (Figure). In 2016, participants provided blood samples and methylation and genomic data was generated. Epigenetic age was calculated as the average of thirteen epigenetic clocks that used different combinations of methylation data. BHe was a composite of stroke, dementia and late-life depression. Stage 1 entailed testing for association between BHe prior to 2016 (exposure) and epigenetic age (outcome). Stage 2 entailed testing for association between epigenetic age (exposure) and BHe occurring after 2016 (outcome). Stage 3 entailed testing for causal associations using Mendelian Randomization (MR). Results: Results are summarized in the Figure. Out of 4,018 participants with epigenomic data, 2,221 (55%) had a history of BHe before 2016. A history of BHe was associated with an older epigenetic age (beta 0.05, SE 0.01; p&lt;0.01). Of the 3,047 study participants with available follow-up data, 1,018 (33%) developed a BHe over a mean follow up of 4 years. Epigenetic age acceleration was associated with higher odds of BHe (OR 1.57, [1.22-2.01]). Causal associations estimated via MR analyses confirmed both results. Conclusion: A history of BHe was associated with epigenetic age acceleration and, conversely, epigenetic age acceleration was linked to a higher risk of brain health events. MR analyses suggest that these associations are causal. These results indicate that more nuanced strategies for ascertaining biological age are needed in stroke research and point to epigenetic clocks as a promising tool for this purpose.

Abstract WMP21: Life's Essential 8 and Brain Health Clinical Outcomes in Middle-Aged Adults

Background: Mounting evidence points to a connection between cardiovascular risk during middle age and brain health later in life. The American Heart Association’s Life’s Essential 8 (LE8) constitute a research and public health construct capturing key determinants of cardiovascular health. We tested the hypothesis that worse LE8 profiles are associated with higher composite risk of the most important clinical endpoints related to brain health. Methods: We conducted a two-stage (discovery and replication) prospective study using data from the UK Biobank (UKB) and All of Us (AoU). We excluded participants with stroke, dementia, or late-life depression (LLD) at baseline. The exposure of interest was the LE8 score, a validated tool that captures the LE8 components (blood pressure, glucose, and cholesterol, body mass index, smoking, physical activity, diet, and sleep duration), organized in 3 categories. The outcome of interest was a composite of stroke, dementia, or LLD. We evaluated the associations of interest via multivariable Cox proportional hazard models. Results: The discovery stage included 334,505 UKB participants (mean age 56, 47% female), in whom the unadjusted risk of the composite outcome of interest was 471 (0.7%), 2,224 (1.1%) and 1,143 (1.7%) in participants with optimal, intermediate, and poor cardiovascular health (p&lt;0.001). This association remained significant in multivariable Cox models (optimal versus poor cardiovascular health OR 2.14; 95% CI 1.92 - 2.39; p&lt;0.001). The replication stage included 92,551 AoU participants (mean age 57, 59% female), in whom the unadjusted risk of the composite outcome was 547 (3%), 3,451 (6.2%) and 1,833 (10%) in participants with optimal, intermediate, and poor cardiovascular health (p&lt;0.001). This association remained significant in multivariable Cox models (optimal versus poor cardiovascular health OR 2.20; 95% CI 1.99 - 2.42; p&lt;0.001). Conclusions and Relevance: Among middle-aged UKB and AoU participants, poorer LE8 cardiovascular health profiles were strongly associated with a higher risk of developing a composite endpoint that captures the most important diseases related to brain health. These findings support the utilization of this endpoint in clinical trials focused on brain health.

Abstract 71: Brain Health Outcomes in Sexual and Gender Minority Groups

Background: There is mounting evidence that sexual and gender minority (SGM) groups experience health disparities, but research on brain health status of this underrepresented group is limited. We evaluated whether SGM persons are at higher risk of adverse brain health outcomes compared to cisgender heterosexual (non-SGM) individuals. Methods: We conducted a cross-sectional study in the All of Us Research Program, a population study focused on health disparities enrolling 1 million Americans. We used baseline questionnaires to identify participants from sexual minorities (non-straight e.g., gay, lesbian, bisexual) and gender minorities (gender identity different from sex assigned at birth). We further divided gender minorities into gender diverse (e.g., non-binary) and transgender. The primary outcome was a composite of stroke, dementia, and late-life depression. In secondary analyses, we analyzed SGM subgroups and diseases separately. We used multivariate logistic regression to assess the link between SGM groups and brain health outcomes. Results: We included 393,041 participants (mean age 51, female sex at birth 62%), of whom 39,632 (10%) belonged to SGM groups. Of these, 4,431 (1%) belonged to a gender minority (2,212 [50%] gender diverse and 2,219 [50%] transgender) and 38,528 (10%) to a sexual minority. Full results are shown in the Figure. Compared to non-SGM, SGM individuals had 19% higher odds of the brain health composite outcome (OR 1.19, 95%CI 1.13-1.25). These results were consistent across all SGM subgroups (p&lt;0.05). When assessing individual diseases, all SGM groups had higher odds of late-life depression, all SGM except transgender persons had higher odds of dementia, and gender minority groups had higher odds of stroke. Conclusion: In a large US population study, SGM individuals had a higher rate of adverse brain health outcomes. Further research should explore the structural causes of inequity to advance inclusive and diverse neurological care.

Abstract TP24: C-Reactive Protein, and Homocysteine as a Predictors of Post Stroke Depression Among Stroke Patients: A Meta-Analysis and Meta Regression

Background: Post-stroke depression (PSD) is a common neuropsychiatric complication of stroke associated with poor functional outcome and increased mortality. Its pathophysiology is poorly understood, however, evidence suggests that neuroinflammation in reaction to the stroke could play a role in the development of PSD. Aim: To compare C-reactive protein (CRP), and homocysteine (Hcy) levels in post-stroke patients with and without PSD. Methods: We systematically searched all electronic databases from inception until May 30th 2023. We performed a conventional meta-analysis and adopted the DerSimonian and Laird random-effect model for the study variations [30]. Outcomes were reported as standard mean difference (SMD), and their corresponding 95% confidence interval (95% CI). Results: A total of 12 studies with 3,230 Patients were included in this analysis. The mean age of the overall cohort was 65.7 years with PSD patients appearing to be older than non-PSD patients (mean 68.3 years versus 63.1 years). In terms of gender distribution, there were more females in the PSD group compared with non-PSD groups (44.4% versus 40.7%). Compared to patients without post-stroke depression, it was found that patients with post-stroke depression had a higher levels of baseline CRP levels [SMD 0.16, (95% CI 0.08 to 0.25), p&lt;0.001], and Hcy [SMD 0.14, (95% CI 0.05 to 0.22), p&lt;0.001]. Meta-regression was performed using covariates including age, female gender, hypertension, diabetes mellitus, CAD, widowhood and family history of psychiatric disorder. For CRP there was no effect modifier, while for Hcy it was observed that a personal history of widowhood appeared as an only significant effect modifier (coefficient 1.998, p=0.038). Conclusion: Elevated baseline levels of CRP and Hcy were significantly higher in patients that developed PSD, suggesting that both could play a role in the pathophysiology of PSD and as a potential biomarker for diagnosing risk of depression post stroke.

Cellular Stress, Energy Constraints and the Energy Allocation Hypothesis of Sleep

A growing body of literature demonstrates a critical role for sleep in upregulating diverse biological processes related to protein synthesis, immune function, and cellular housekeeping such as intracellular transport and membrane repair. The energy allocation (EA) hypothesis places sleep in a broader context of resource optimization where sleep–wake partitioning of metabolic operations optimizes resource utilization. The EA hypothesis of sleep carries important implications in health, disease, and homeostatic mechanisms. Specifically, conditions that lead to cellular stress, energy constraints or depression of neuronal activity, such as epilepsy, ischemic stroke or cortical spreading depression, are here proposed to follow similar conserved processes that favor sleep. This review examines the role of local mechanisms, including cytokine release or the accumulation of adenosine, in downregulating wakefulness to favoring sleep, loss of functional connectivity and the upregulation sleep-coupled processes that promote survival.

Comparison of Upper Extremity Function and Daily Use in Individuals with and without Post Stroke Depression

Background Post-stroke depression (PSD) is a frequent psychiatric complication, however very few studies have investigated its relation to the affected upper extremity (UE) post-stroke. Objective. To compare the affected UE in terms of motor impairment, functional ability, and daily-use in individuals with and without PSD during the first 6 months post-stroke. Methods This study analyzed data from a previous cohort; participants were assessed at rehabilitation admission (T1), 6 weeks (T2), and 6 months (T3) post-stroke. At each time point we compared between participants with and without PSD (Geriatric Depression Scale score ≥ 5). The Fugl-Meyer Motor Assessment assessed motor impairment, Action Research Arm Test assessed functional ability, and the Rating of Everyday Arm-Use in the Community and Home assessed daily-use. Independence in daily activities and cognition were also assessed. Results A total of 116 participants were recruited, 38% had PSD at T1. No significant differences were found between groups at T1 and T2. However, significant differences (z = −5.23 to −2.66, p < .01) were found between groups for all UE measures at T3; participants with PSD had lower motor and functional ability and less daily hand-use than participants without PSD. At T3 participants with PSD were also less independent in daily-living. Conclusions PSD is associated with greater UE motor, functional, and daily-use disability at 6 months post-stroke. Our findings underscore the negative impact of PSD on UE during the crucial transition period when individuals return home and integrate back into the community. Further research is needed to delineate the effect of change in PSD status on UE outcomes post stroke.

Effects of Jiawei Yiqihuoxue decotion for the treatment of post stroke depression and anxiety.

This study retrospectively assessed the effects of Jiawei Yiqihuoxue decotion (JWYQHXD) for the treatment of post stroke depression and anxiety (PSDA). This retrospective study included 72 patients who had undergone PSDA. All patients received flupentixol and melitracen and were divided into treatment (n = 36) and control (n = 36) groups. In addition, all the patients in the treatment group underwent JWYQHXD treatment. All patients in both groups were treated for 8 weeks. The primary outcomes were depression (assessed by Hamilton Depression Scale scores) and anxiety (evaluated by Hamilton anxiety scale scores). The secondary outcomes were quality of life (assessed using the 36-item short form health survey) and adverse events. We collected and analyzed the outcome data before and after treatment. After treatment, patients in the treatment group did not show greater relief on depression (Hamilton depression scale, P > .05) or anxiety (Hamilton anxiety scale, P > .05) than those in the control group. However, there were significant differences in quality of life 36-item short form health survey (physical function, P = .02; physical role, P = .01; and general health, P = .04) between the 2 groups after treatment. This study found that the JWYQHXD may help improve the quality of life of patients with PSDA. Future prospective studies are warranted to confirm these findings.

Acute stress symptoms 1-2 weeks after stroke predict the subsequent development of post-traumatic stress symptoms: A prospective cohort study.

To date no research has examined the potential influence of acute stress symptoms (ASD) on subsequent development of post-traumatic stress disorder (PTSD) symptoms in stroke survivors. Our objective was to examine whether acute stress symptoms measured 1-2 weeks post-stroke predicted the presence of post-traumatic stress symptoms measured 6-12 weeks later. Prospective within-groups study. Fifty four participants who completed a measure of acute stress disorder at 1-2 weeks following stroke (time 1) and 31 of these participants completed a measure of posttraumatic stress disorder 6-12 weeks later (time 2). Participants also completed measures of stroke severity, functional impairment, cognitive impairment, depression, anxiety, pre-morbid intelligence and pain across both time points. Some 22% met the criteria for ASD at baseline and of those, 62.5% went on to meet the criteria for PTSD at follow-up. Meanwhile two of the seven participants (28.6%) who met the criteria for PTSD at Time 2, did not meet the ASD criteria at Time 1 (so that PTSD developed subsequently). A hierarchical multiple regression analysis indicated that the presence of acute stress symptoms at baseline was predictive of post-traumatic stress symptoms at follow-up (R2 = .26, p < .01). Less severe stroke was correlated with higher levels of post-traumatic stress symptoms at Time 2 (rho = .42, p < .01). The results highlight the importance of early assessment and identification of acute stress symptoms in stroke survivors as a risk factor for subsequent PTSD. Both ASD and PTSD were prevalent and the presence of both disorders should be assessed.

Factors Associated with Post-Non Hemorrhagic Stroke Depression: a cross-sectional study

Background: Post-stroke patient depression can result in delays in stroke recovery and healing. The degree of severity of stroke will cause neurological deficits which can become stressors that will affect individual coping mechanisms.Objective: This research aims to analyze factors associated with non-hemorrhagic post-stroke depression.Methods: Analytical observational with a cross-sectional approach. The research was conducted at the Neurology Clinic of RSUD dr. R. Goeteng Taroenadibrata Purbalingga. The population is 435 post-stroke non-hemorrhagic patients. The sample is 104 respondents with the sampling technique used consecutive sampling. The instruments used were the Brief COPE, NIHSS, and PHQ-9. Bivariate analysis used the Kendall-Tau correlation test.Results: The majority of respondents were elderly, male, primary school education level/equivalent, married, live with husband/wife and children, left hemisphere lesion location, had stroke duration 2 years, did not experience recurrent strokes, hypertension, had problem-focused coping and mild stroke severity with varying degrees of depression. Age, gender, marital status, living together, location of the lesion, duration of stroke, stroke frequency, comorbidities and coping mechanisms were not significantly related (p0.05) while education level and stroke severity was significantly associated with post-stroke depression (p0,05).Conclusions: There is a significant relationship between education level and severity of stroke with post-stroke depression. Nurses can also motivate patients to always take medication regularly, increase patient knowledge about stroke and depression, or implement non-pharmacological therapy such as Range of Motion (ROM) so that they can help reduce the severity of a stroke and prevent or reduce the occurrence of depression after non-hemorrhagic stroke.

Prevalence of Post Stroke Depression and Anxiety Among Patients Admitted in Khyber Teaching Hospital Peshawar

Introduction: Stroke is a life-threatening medical condition that can result in lifelong brain damage, complications, and death. It is the second leading cause of death worldwide and could soon overtake as the biggest cause of death globally. This can be produced by ischemia from a thrombosis or embolism, or a hemorrhage. As a result, the brain’s damaged area is unable to operate, causing one or more limbs on one side of the body to become immobile, inability to recognize or produce speech, or seeing only one side of the visual field. Objective of the Research: To determine the prevalence of Post Stroke Depression and anxiety among stroke patients admitted in Khyber teaching hospital Peshawar Methodology: A descriptive cross-sectional study was carried out to determine the prevalence of PSD and anxiety among stroke patients admitted at Khyber teaching hospital Peshawar. Data was collected through a questionnaire named HADs scale from participants. The sample size calculated for the research study was 109. The convenience sampling technique was used in the current study. Results: The findings of the study provide a baseline of information about the prevalence of Post Stroke Depression (PSD) and anxiety among stroke patients admitted in Khyber teaching hospital Peshawar. The prevalence of depression was 86(63.3%) and anxiety was 91(83.5%). Conclusion: In current study we had concluded a high prevalence of post stroke depression and anxiety ranging from 65-74 years of age in Khyber teaching hospital Peshawar. So, we concluded that females suffering from stroke have more chances of post stroke depression.