Prevalence of Post-Stroke Depression in a Nigerian Sample
DOI:
https://doi.org/10.34058/njmr.v14i1.2.47Keywords:
Stroke, post- stroke depression, prevalence, Nigerian subjectsAbstract
Background: Post-stroke depression has been identified as a significant problem confronting stroke survivors and imparting negatively on their rehabilitation potential.Objective: The purpose of this study was to investigate the prevalence of post-stroke depression in a Nigerian sample.
Method: Participants for this study comprised fifty- one (51) stroke patients receiving physiotherapy rehabilitation in a major tertiary hospital. Inclusion criteria were a diagnosis of cerebrovascular disease with a resultant hemiparesis and intact cognition based on the mini mental state examination. Exclusion criteria were transient ischaemic attack (TIA), pre-morbid history of depressive disorder and disability, as well as aphasia. Each subject’s post stroke depression was assessed using the Depression Anxiety Stress Scale-21 (DASS-21), designed to measure the three negative affective states of depression, anxiety and stress. The DASS also assesses dysphasia, hopelessness, devaluation of self, anhedonia, lack of interest and inertia, and permits patients to be classified as depressed or not depressed.
Descriptive and inferential statistics of mean, standard deviation, percentages and chi-squares were used for analysis using the SPSS 14 .0 windows version.
Results: Thirty-one (31) males and twenty (20) females with a mean age of 52+5.9 years participated in this study. Thirty-one (60.8%) were right hemiplegics while twenty (39.2%) were left hemiplegics. The mean onset of stroke for all the participants was 11.3+5.6 months. There was no significant difference between the male and female participants (p>0.954), but between right and left hemiplegics (P<0.035). Significant differences were also observed in occurrence of post-stroke depression between the males and the females (p<0.01) and between left and right hemiplegics (P<0.13).
Conclusion: The study has established the occurrence of post-stroke depression among Nigerians. It is hereby suggested that post-stroke depression should be taken into consideration in rehabilitating stroke survivors.
References
Aben I, Verhey F, Strik J, Lousberg R, Lodder J, Honig A (2003). A comparative study into the one year cumulative incidence of depression after stroke and myocardial infarction. J Neurol Neurosurg Psychiatry 74: 581–585.
Astrom M, Adolfsson R, Aslund K (1993). Major depression in stroke patients: a 3-year longitudinal study. Stroke. 24: 976–982.
Berg A, Palomaki H, Lehtihalmes M, Lonnqvist J, Kaste M (2003). Post-stroke Depression: An 18-Month Follow-Up. Stroke 34: 138–143.
Bronner LL, Kanter DS, Manson JE. (1995) Primary prevention of stroke. New England Journal of Medicine; 333(21): 1392–1400.
Carson AJ, MacHale S, Allen K, Lawrie SM, Dennis M, House A(2000). Depression after stroke and lesion location: a systematic review. Lancet; 356(9224): 122–6.
Creed F, Morgan R, Fiddler M, Marshall S, Guthrie, E. & House AO (2002). Depression and anxiety impair health-related quality of life and are associated with increased costs in general medical inpatients. Psychosomatics, 43(4): pp.302–309.
Daza P, Novy DM, Stanley MA and Averill P (2002). The Depression Anxiety Stress Scale-21: Spanish translation and validation with a Hispanic sample. Journal of Psychopathology and Behavioral Assessment 24: 195–205.
House A (1987). Depression after stroke. British Medical Journal (Clin Res Ed). 294(6564): 76–78.
Jonkman EJ, de Weerd AW, Vrijens NL( 1998 )Quality of life after a first ischemic stroke. Long-term developments and correlations with changes in neurological deficit , mood and cognitive impairment. Acta Neurologica Scandinavia; 98(3): 169–175.
Lesperance F, Frasure-Smith N, Talajic M, Bourassa MG (2002). Five year risk cardiac mortality in relation to initial severity and one year changes in depression symptoms after myocardial infaction. Circulation 105: 1049–1053.
Lovibond PF, Lovibond SH (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther; 33: 335–343.
Lovibond PF (1998). Long–term stability of depression, anxiety, and stress syndrome. J Abnorm Psychol. 107: 520–526.
Ogun SA, Ojini FI, Ogungbo B, Kolapo KO, Danesi MA (2005). Stroke in south western Nigeria. Stroke 36: 1120–1122.
Paolucci S, Gandolfo C, Provinciali L, Torta R, Sommacal S, Toso V (2005). Quantification of the risk of post-stroke depression: the Italian multicentre observational study DESTRO. Acta Psychiatr Scand 112: 272–278.
Peveler R, Carson A, Rodin G (2002). ABC of psychological medicine; Depression in medical patients, BMJ 325: 149–152.
Ouimet MA, Primeau F, Cole MG (2001). Psychosocial risk factors in post-stroke depression: a systematic review. Can J. Psychiatry 46: 819–828.
Robert T, Katherine S, Sanjit B, Norine F, Mark S. (2005). Evidence Based Review of Stroke rehabilitation-Post-Stroke Depression. (8th edition). Western Ontario.
Singh A, Herrmann N, Black S (1998). The importance of lesion location in poststroke depression: A critical review Can J Psychiatry;43: 921–220.
Spalletta G, Ripa A, Caltagirone C (2005). Symptom profile of DSM-IV major and mirror depressive disorders in first-ever stroke patients. Am J Geriatr Psychiatry 13: 108–115.
Starkstein SE, Robinson RG, Price TR (1998) Comparison of spontaneously recovered versus nonrecovered patients with post-stroke depression. Stroke 4: 1491–1496.
Whyte EM, Mulsant BH, Vanderbilt J, Dodge HH, Ganguli M (2004). Depression after stroke: a prospective epidemiological study. JAGS; 52: 774–778.
World Health Organisation: (1989). Recommendation on Stroke Prevention, Diagnosis, and Therapy: Report of the WHO Task Force on Stroke and Other Cerebrovascular Disorders. Stroke; 20: 1407–1431.
