Over Half of Stroke Patients Face Depression; Stroke Severity and Daily Function Strong Indicators, Study Finds

The study identified significant associations with vascular risk factors such as diabetes mellitus (OR 4.12), hypertension (OR 1.96), and low education levels (OR 1.46), as well as stroke location, particularly left-sided strokes (OR 1.69). Additionally, the NIH Stroke Scale scores (AUC 0.797) and activities of daily living (ADL) scores (AUC 0.741) emerged as the strongest predictors of depression in these patients. The findings emphasize the importance of addressing both the physical and mental health aspects of stroke recovery.

Yifan Li, Department of Integrative Traditional Chinese and Western Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China, and colleagues aimed to examine the prevalence and severity of depression in ischaemic stroke patients and identify its contributing factors through a cross-sectional study conducted over 6 months.

For this purpose, the researchers included 499 ischaemic stroke patients who met the diagnostic and inclusion criteria. Depression levels were assessed using the Hamilton Depression Rating Scale (HAMD), while demographic, clinical, and self-reported data were collected. Neurological deficits were evaluated with the National Institutes of Health Stroke Scale (NIHSS), and activities of daily living (ADL) were assessed using the ADL scale. Chi-squared tests and t-tests compared the mild and moderate depression groups.

Multiple logistic regression was used to identify independent predictors of depression, and receiver operating characteristic (ROC) curves were employed to evaluate the predictive effectiveness of risk factors.

The study revealed the following findings:

• Of the 499 patients, 305 (61.1%) had mild depression, and 194 (38.9%) had moderate depression, with a mean HAMD score of 15.27 ± 6.43.
• There were no significant differences between groups in hypertension, diabetes mellitus, education level, stroke location, ADL score, and NIHSS score.
• Logistic regression identified hypertension (OR = 1.963), diabetes mellitus (OR = 4.126), lower education level (OR = 1.460), left-sided stroke (OR = 1.690), lower ADL scores (OR = 0.718), and higher NIHSS scores (OR = 1.213) as independent predictors of depression.
• ROC analysis showed that NIHSS (AUC = 0.797) and ADL (AUC = 0.741) scores were the most effective predictors of depression.

The findings of the study highlighted that depression is common among ischaemic stroke patients and is significantly influenced by factors such as vascular risk conditions, education level, stroke location, neurological deficits, and daily living abilities. The research underscores the high incidence of post-stroke depression and identifies key contributors, including vascular conditions, stroke location, and functional impairments.

"The NIHSS and ADL scores emerged as strong predictors of depression, emphasizing the need for dynamic assessments in stroke patients," the researchers noted.

They further concluded, "Tailored psychological interventions and rehabilitation addressing these risk factors can improve physical and mental well-being, ultimately enhancing patients' quality of life. Early identification and timely intervention are crucial for better outcomes."

Reference:

Li Y, Qin W, Chen Y, Zhang D, Zhao Y. Prevalence and Associated Factors of Depression in Patients with Ischaemic Stroke: A Cross-Sectional Study. Neuropsychiatr Dis Treat. 2025;21:875-883. https://doi.org/10.2147/NDT.S514184