A cross-sectional study on post-stroke depression and the quality of life

Abstract

Background: Post-stroke depression (PSD) is a common mood disorder associated with stroke. By investigating the differences in life quality factors among stroke survivors, the results of this study offer insights into how to better prevent and manage the onset and progression of depression.

Methods: This study is a cross-sectional study that selected patients receiving treatment in the Department of Rehabilitation Medicine at Hebei University Affiliated Hospital from September 1 to November 30, 2023. The inclusion criteria for this study were as follows: 1. Age ≥ 18 years; 2. Diagnosis of hemorrhagic or ischemic stroke confirmed by imaging examination. The exclusion criteria included: 1. A history of psychiatric disorders such as depression or anxiety prior to the onset of the illness; 2. History of psychiatric medication use before the onset; 3. Functional impairments, such as speech, cognitive, or consciousness disorders, that hinder cooperation with the survey questionnaire. Ultimately, a total of 131 patients were included in the study. Based on the results of the Patient Health Questionnaire-9 (PHQ-9), patients were divided into the PSD group and the non-PSD group. The primary evaluation metrics included the General Self-Efficacy Scale (GSES), Visual Analogue Scale (VAS), modified Rankin Scale (mRS), and Fatigue Assessment Scale (FAS), allowing for a comparison of demographic, clinical data, and evaluation metrics between the two groups. Statistical analysis was performed using SPSS version 25.0, and GraphPad Prism version 9.0 was used for graphical representations.

Results: The morbidity rate of PSD in this study was 48%, which was slightly higher than the global statistical data. The demographic data did not show any statistical differences in terms of age, sex, history of smoking and drinking, or occupation, but they did show a significant difference in terms of education level (p < 0.05), which was primarily related to low education level in the PSD group. In contrast, the clinical data did not show any differences in terms of stroke type, pathogenic site, or medical history (p > 0.05).

Conclusion: In this study, statistical results indicated no significant difference in the mRS between the two groups. However, the GSES, VAS, and FAS showed significant differences. This suggests a strong correlation between GSES, VAS, and FAS with the occurrence of PSD, indicating that these factors may serve as predictors for PSD. In medical practice, focusing on patients' self-efficacy, pain, and fatigue levels could facilitate recovery. When developing rehabilitation plans, it is crucial to minimize patients' feelings of self-defeat, enhance their self-efficacy, and manage fatigue effectively. Furthermore, reinforcing pain management throughout the rehabilitation process may promote more effective patient recovery.

Keywords: Fatigue severity scale; General self-Efficacy score; Post-stroke depression; Post-stroke fatigue; Quality of life.

Fig. 1

Distribution characteristics of GSES score results for two sets of data, including median and quartile, with P <0.05

Fig. 2

Distribution characteristics of VAS score results for two sets of data, including median and quartile, with P <0.05

Fig. 3

Distribution characteristics of the scoring results of two sets of FAS data, including median and quartile, with P <0.05

Fig. 4

Distribution characteristics of two sets of mRS data scoring results, including median and quartile, with P >0.05