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. 2025 Apr;15(4):e70483.
doi: 10.1002/brb3.70483.

Analysis of the Incidence and Influencing Factors of Depression in the Acute Stage of Ischemic Stroke: A Retrospective Clinical Study

Xiao Zhou  1   2 , Saquib Waheed  3   4 , Xinyin Cao  2   5 , Madiha Fatim  3   4 , Xiaohong Fu  4 , Shilong Deng  2   5 , Chong Chen  5 , Sudong Qi  2 , Hao Sun  2 , Ke Cheng  2   5 , Libo Zhao  2   5 , Changlong Zhou  1   2
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Analysis of the Incidence and Influencing Factors of Depression in the Acute Stage of Ischemic Stroke: A Retrospective Clinical Study

Xiao Zhou et al. Brain Behav. 2025 Apr.

Abstract

Background: Poststroke depression (PSD) is a common complication following a stroke, but the risk factors for its onset remain controversial. The purpose of this study was to investigate the incidence of PSD and its relationship with stroke sites to provide more evidence for the early identification of high-risk patients with PSD.

Methods: This retrospective clinical study recruited acute ischemic stroke patients and assessed them for 2 weeks after the onset. Blood samples were collected from the patients upon admission for routine blood tests and blood biochemical analysis. Stroke patients with the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) depressive diagnosis were rated for severity using the Hamilton Depression Rating Scale (HAMD), as measured by the National Institutes of Health Stroke Scale (NIHSS). Stroke prognosis was measured by the Modified Rankin Scale (mRS).

Results: A total of 192 stroke patients were evaluated. Two weeks after the stroke, 73 patients developed depression, and the incidence of PSD was 38.02%. The proportion of depression composition after 2 weeks was as follows: 63 cases were mild depression, accounting for 91.8%; 6 cases were moderate depression, accounting for 8.2%. In univariate analysis, red blood cell (RBC) count, thalamic infarction, mRS score, and mini-mental state examination (MMSE) score were identified as risk factors associated with the occurrence of PSD. Multivariate logistic regression analysis further confirmed that RBC count, mRS score, and MMSE score were significantly correlated with PSD development.

Conclusion: This study suggests that patients with thalamic infarction and TOAST type I stroke should receive increased clinical attention. RBC count, high mRS scores, and high MMSE scores are three independent risk factors for PSD occurrence.

Keywords: imaging; ischemic stroke; poststroke depression; risk factors.

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Conflict of interest statement

The authors declare no conflicts of interest.

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