Predictors and Consequences of Post-Stroke Depression in a Sample of Egyptian Patients

Background and objectives In spite of its high incidence, post-stroke depression (PSD) is still under diagnosed and the risk factors for its development have not been clearly delineated. The present study was set to detect different predictors for the development of PSD and assess potential risk factors influencing the occurrence of the condition while also examining the consequences of its severity. Patients and methods: 120 Egyptian stroke patients were administered the Mini International Neuropsychiatric Interview (M.I.N.I.) and a thorough neurological examination and CT scan or MRI for localization of the lesion. Other measurements were Hamilton Rating Scale for Depression (HAM-D), Barthel Index (B.I) for activity of daily living assessment, Quality of Life Depression Rating scale (QLDR) and Caregiver Strain Index (CSI) for assessment of the stress level. Results: We report that the main risk factors for the development of PSD in the study sample were male gender (63%), younger age group, frontal lesions irrespective of the side (35%), presence of stressful life events (22%) and presence of post-stroke functional impairments (73%), whereas the main factors affecting the severity of PSD included female gender (77.2%), lower socioeconomic class (70.4%) and the severity of post-stroke functional impairments (90.9%). We also report that the main consequences of PSD encountered were significant impairment of the quality of life (QOL) and significant increase of caregiver stress compared to a non PSD group (p 0.001). Conclusion: We conclude that PSD should be carefully evaluated in all stroke patients and recommend further prospective studies targeting the immediate and remote complications of PSD.