Disability and depression among stroke survivors attending rehabilitation facilities at three designated tertiary care hospitals in Bangladesh: A cross-sectional study

Abstract

Background Poststroke depression (PSD) is a highly prevalent and serious mental health condition affecting a significant proportion of stroke survivors worldwide. While its exact causes remain under investigation, managing PSD presents a significant challenge. Aim This study aimed to evaluate the prevalence and predictors of depression among Bangladeshi stroke victims. Methods A cross-sectional study was carried out with 725 stroke victims who were receiving medical care at three designated tertiary care hospitals in Sylhet from January to December 2023. Depression and disability were measured using the Patient Health Questionnaire-9 and the Modified Rankin Scale. Logistic regression analysis was employed to examine the predictors linked to depression. Results According to the study, 80.8% of individuals had moderate to severe disability, and 58.1% of them experienced a moderate to severe level of depression. Individuals who had hemorrhagic stroke (AOR 1.31, 95% CI: 0.77–2.25), repeated episodes (AOR 3.41, 95% CI: 1.89–6.14), tobacco use (AOR 1.76, 95% CI: 1.16–2.67), or coexisting health conditions (AOR 1.68, 95% CI: 1.00–2.82) exhibited elevated levels of depression. Participants whose medical expenses covered by relatives or others were six times more likely to experience depressive symptoms (AOR 6.32, 95% CI: 1.61–24.76). Individuals who did not receive rehabilitation services had two times greater odds of being depressed (OR 1.85, 95% CI: 1.23–2.77, p = 0.003). Consequently, individuals with low functional status had eleven times greater levels of depression (AOR 11.03, 95% CI: 7.14–17.04). Conclusion More than half of the participants in this present study reported moderate to extreme levels of depression which is a serious health issue among Bangladeshi stroke survivors. Understanding the predictors of depression linked to stroke could enhance the effectiveness of therapeutic interventions for this condition. In addition, multidisciplinary teams should work collaboratively to address this serious issue.