Prevalence of Post-stroke Depression and Associated Factors in Selected Tertiary Care Hospitals in Sri Lanka

Abstract

Background: The prevalence of stroke and stroke-related disabilities are increasing in low and middle-income countries. Post-stroke depression (PSD) is one of the common consequences of stroke that is associated with poor quality of life. Objective: To determine the prevalence of PSD and associated factors among the post-stroke patients attending to neurology clinics of selected tertiary care hospitals in Sri Lanka. Methods: A descriptive cross-sectional study was conducted with the participation of 322 patients with stroke attending neurology clinics at three tertiary care centers in Colombo and Galle districts in Sri Lanka (National Hospital Sri Lanka, Teaching Hospital Karapitiya, Colombo South Teaching Hospital). Convenient sampling technique was used to collect data. The validated Sinhala version of the Patient Health Questionnaire (PHQ-9) was used to screen depression among patients. A pre-tested interviewer-administered questionnaire was used to assess the associated factors of PSD. Chi-squared test, one way ANOVA and t-test were used to analyse the data. Results: The mean age(±SD) of the participants was 60.8(±11.9) years. Among study participants, 59.6% (n=192) were males and only 40.4% (n=130) were females. The majority (84.5%) of the participants had ischemic strokes (n=272). Nealy one-third of them (69.6%) had hypertension. The prevalence of moderate depression was 37.3% (n=120). Of all, 25.5% (n=82) had moderately severe depression and 8.7% (n=28) had severe depression. Socio-demographic factors such as age, gender, level of education, income, clinical characteristics such as type of stroke, level of cognition, hemiplegia, and having concurrent non-communicable diseases were significantly associated with PSD (p<0.05). Conclusions: Nearly half of the patients with stroke had severe PSD. Identified modifiable factors including the hemiplegia and level of cognition should be further evaluated and treated by healthcare providers to improve the quality of life of patients. Keywords: Associated factors, Post-stroke depression, Prevalence 68