Risk factors of post-stroke depression among stroke survivors in Lagos, Nigeria

Afr J Psychiatry (Johannesbg). 2009 Feb;12(1):47-51. doi: 10.4314/ajpsy.v12i1.30278.


Objective: Stroke is an important neurological problem and a leading cause of death in clinical practice. Among survivors, over half have significant disabilities; and/ or psychiatric complications most especially Post-stroke depression (PSD). The study aimed to establish prevalence and risk factors for post stroke depression.

Method: A prospective study carried out among selected stroke survivors in Lagos University Teaching Hospital (LUTH). Subjects included those who satisfied the WHO definition of stroke. The necessary socio-demographic data was obtained from each subject; the Depression Anxiety Stress Scale-21 (DASS-21) and Modified Motor Assessment Scale (MMAS) were administered. Risk factors of PSD studied were gender, laterality of stroke, post stroke functional impairment and post stroke duration before clinical presentation.

Results: A total of 51 stroke survivors were studied, made up of 31 (60.8%) males and 20 (39.2% ) females. The mean age was 52.5+/-5.9 years; and age range of 40-64 years. From assessment with the depression subscale of DASS-21, 38 (74.5% ) of the subjects were normal and the rest 13 (25.5% ) had depression. Risk factors found to be statistically significant for PSD in the study included: gender (X(2)=10.3 at p=0.001) and stroke laterality ( X (2)=6.1 at p = 0.013). However, there were no statistically significant differences for mean post-stroke duration before clinical presentation and PSD ( "t" =3.5 and p= 0.073) ; and post-stroke disability as shown by mean MMAS scores and PSD ( "t" =7.6 and p= 0.084).

Conclusion: Depression was found to be an important complication among stroke survivors in our study. Important risk factors found for PSD included gender and laterality. The findings emphasized a need for appropriate health facilities and for stroke survivors to present early for treatment to attenuate stroke complications.

MeSH terms

  • Adult
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology*
  • Developing Countries*
  • Disability Evaluation
  • Dominance, Cerebral
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mental Status Schedule / statistics & numerical data
  • Middle Aged
  • Nigeria
  • Personality Inventory / statistics & numerical data
  • Prospective Studies
  • Psychometrics
  • Risk Factors
  • Sex Factors
  • Stroke / complications
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Stroke / psychology*
  • Survivors / psychology*
  • Survivors / statistics & numerical data*