Prevalence of Depression Amongst Stroke Survivors in Two Regional Hospitals in Cameroon

Abstract

Introduction. Stroke has numerous complications, amongst which is post-stroke depression (PSD). This condition, which has a significant impact on functional recovery and rehabilitation of stroke survivors, unfortunately, is often unrecognized and underdiagnosed.

Objectives. We therefore sought to determine the prevalence of post stroke depression and associated factors at the Bamenda and Buea regional hospitals.

Methods. This was a cross-sectional study that lasted 5 months between January and May 2020. We included, all stroke survivors who were at least 2 weeks post the event with good verbal communication. Stroke survivors with pre-existing depression, mental illness as well as, those with post-stroke aphasia, were excluded. The presence and severity of depression were measured using the Patient Health Questionnaire 9 (PHQ-9). Impairment in activities of daily living was assessed with the Barthel’s Index. Associated factors were identified using the Chi-square test.

Results. We recruited 68 participants, with a male predominance (sex ratio: 1.13). The mean age was 59.76years (SD= 11.51years). The majority of strokes were ischemic (72.1%) and just over half (54.8%) of those with post stroke depression were within 3 months of the onset of stroke. The prevalence of PSD was 45.6% (95% CI: 33.5%-58.1%), with a higher proportion in females (50%) than males (41.7%), although this was not statistically significant. One-third of those with PSD had thoughts of self-harm or suicide. Impairment in activities of daily living was the only associated factor, significantly associated with the occurrence of PSD (p<0.001). There was no association between socio-demographic as well as the type of stroke and time since stroke and the occurrence of PSD.

Conclusion. The prevalence of post-stroke depression is high and is strongly associated with impairment in activities of daily living.