From stroke to depression: The need for systematic screening for post-stroke depression

Abstract

Background: Post-stroke depression (PSD) negatively impacts the physical and mental well-being of stroke survivors. However, data on the prevalence and risk factors of PSD in African countries such as Cameroon are limited. Aim: This study aims to determine the prevalence and factors associated with PSD among stroke survivors at a hospital in Cameroon and inform clinical practice. Setting: The study was carried out in the Nkwen Baptist Hospital in the North West region of Cameroon. Methods: This was a hospital-based cross-sectional study. Stroke patients were systematically screened for PSD using the patient health questionnaire (PHQ-9). PSD was present if a patient scored ≥ 4 points on the scale. The multidimensional scale of perceived social support was used to assess the level of social support, the modified Rankin tool and Barthel index were used to assess functional independence, and the Fatigue assessment tool was used to assess post-stroke fatigue. A multivariate analysis was performed to identify factors associated with PSD. Results: A total of 103 patients were included in the study. The mean age was 55.55 ± 12.15. Most patients were males (58.25%). The mean depression score was 5.17 ± 6.26. The overall prevalence of PSD was 36.89%. A higher functional impairment, post-stroke fatigue, perceived social support, recent stroke and being divorced were all associated with high PSD scores. Conclusion: In this study, we found a high prevalence of PSD using a systematic screening approach, suggesting that systematic screening for PSD can lead to early detection and management. Contribution: Systematic screening for PSD in stroke patients can lead to early diagnosis and, consequently, early initiation of treatment. Integration of mental health support and care as part of the routine stroke is warranted.

Keywords

• stroke, post-stroke depression, prevalence, mental health, stroke survivors