Magnitude and determinants of depression in acute stroke patients admitted in a rural tertiary care hospital

BACKGROUND: Depression is one of the most frequent neuropsychiatric disturbances after a cerebrovascular stroke. The frequency of depression in stroke patients has varied widely in different populations. Post stroke depression is an important factor limiting recovery and rehabilitation in acute stroke patients. SETTINGS AND DESIGN: A cross-sectional hospital-based study was performed in acute stroke patients admitted in the department of Medicine of a rural teaching tertiary care hospital in central India. MATERIALS AND METHODS: In all consecutive acute stroke inpatients, the intensity of depression was assessed by a trained person through a questionnaire, Montgomery-Asberg Depression Rating Scale (MADRS), who is blind of the diagnosis and investigations of the patient. Another study person collected the data including demographics, co-morbid diseases or risk factors. Radiological imaging data was noted from the CT/MRI head reports of stroke patients. RESULTS: Of the total 107 stroke patients, 60 (56%) were males and 47 (44%) were females. Sixty-one (57%) of the 107 stroke patients had depression. Of the 107 stroke patients, 35 (33%) had mild depression, 22 (20%) had moderate depression and 4 (4%) had severe depression. The age, gender, education status and co-morbidities of the stroke patient were not associated with depression. The association of socio-economic status and left-sided lesions with depression was found to be statistically significant (P < 0.05). Type and location of the lesion were not associated with depression. CONCLUSION: Post-stroke depression was present in more than half of the stroke patients and was related to socio-economic status and left-sided hemisphere lesions.