Department of Internal Medicine, College of medicine and health sciences, University of Gondar, Gondar, Ethiopia.
MDR tuberculosis treatment center, University of Gondar Hospital, Gondar, Ethiopia.
BMC Neurol. 2022 Dec 1;22(1):446. doi: 10.1186/s12883-022-02982-x.
Stroke is one of the most common causes of disability among adults. Post-stroke depression (PSD) is a frequent neuropsychiatric complication in stroke patients. Despite the increasing prevalence of stroke, there is a paucity of data on PSD and its determinants among stroke survivors in developing countries like Ethiopia. We aim to assess the factors associated with PSD in survivors of stroke.
A hospital-based unmatched case-control study was conducted during the period of February to July 2020 at University of Gondar Hospital among stroke survivors. Study subjects were recruited consecutively. Socio-demographic and clinical data were obtained from patients' interviews and medical record reviews. A diagnosis of PSD was made using the Patient Health Questionnaire (PHQ-9). EpiData version 3.1 was used to enter data, and SPSS version 26 was used to analyze it. Bivariate and multivariate logistic regressions were fitted to identify associated variables. The adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value 0.05 were used to determine the significance of the association.
A total of 240 stroke survivors were included in the study (80 cases and 160 controls). The mean age was 60.8 years (SD ± 14.3) with an equal sex distribution. Variables statistically associated with PSD were male gender (AOR = 3.5, 95% CI: 1.64-7.46 C, P-value = 0.001), subcortical location of the largest lesion (AOR = 2.42, 95% CI: 1.06-5.56, p-value = 0.036), severity of the stroke (AOR = 52.34, 95% CI:10.64-256.87, p-value = 0.000), physical disability (AOR = 5.85. 95% CI:1.94-17.65, p-value = 0.002), previous history of stroke or transient ischemic attack (AOR = 5.90, 95% CI:2.04-17.10, p-value = 0.001) and ischemic heart disease (AOR = 9.97, 95% CI:3.4-29.22, p-value = 0.000).
Important factors in the occurrence of PSD in this study include prior history of stroke, physical disability, severity of the stroke, subcortical location of the lesion, male gender, and ischemic heart disease. Stroke patients with such factors need routine screening for PSD, particularly in LMICs where there is uncoordinated post-stroke care, a shortage of neurologists and mental health practitioners.
中风是成年人残疾的最常见原因之一。中风后抑郁（PSD）是中风患者常见的神经精神并发症。尽管中风的发病率不断上升，但在埃塞俄比亚等发展中国家，中风幸存者的 PSD 及其决定因素的数据仍然很少。我们旨在评估与中风幸存者 PSD 相关的因素。
这是一项在 2020 年 2 月至 7 月期间在贡德尔大学医院进行的基于医院的病例对照研究，研究对象为中风幸存者。采用连续抽样的方法招募研究对象。从患者访谈和病历回顾中获取社会人口统计学和临床数据。使用患者健康问卷（PHQ-9）进行 PSD 诊断。使用 EpiData 版本 3.1 输入数据，使用 SPSS 版本 26 进行分析。采用双变量和多变量逻辑回归来确定相关变量。使用具有 95%置信区间（CI）和 p 值<0.05 的调整后的优势比（AOR）来确定关联的显著性。
共有 240 名中风幸存者纳入研究（80 例病例和 160 例对照）。平均年龄为 60.8±14.3 岁，性别分布均衡。与 PSD 统计学相关的变量为男性（AOR=3.5，95%CI：1.64-7.46，P 值=0.001）、最大病灶的皮质下位置（AOR=2.42，95%CI：1.06-5.56，p 值=0.036）、中风严重程度（AOR=52.34，95%CI：10.64-256.87，p 值=0.000）、身体残疾（AOR=5.85，95%CI：1.94-17.65，p 值=0.002）、既往中风或短暂性脑缺血发作史（AOR=5.90，95%CI：2.04-17.10，p 值=0.001）和缺血性心脏病（AOR=9.97，95%CI：3.4-29.22，p 值=0.000）。
本研究中 PSD 发生的重要因素包括既往中风史、身体残疾、中风严重程度、病灶皮质下位置、男性和缺血性心脏病。具有这些因素的中风患者需要常规筛查 PSD，特别是在中风后护理不协调、神经病学和心理健康从业者短缺的中低收入国家。
