Psychological factors determine depressive symptomatology after stroke

OBJECTIVE: To identify psychological factors related to post-stroke depressive symptoms. DESIGN: Cross-sectional study. Patients were assessed at two months post stroke. SETTING: Patients with stroke from six general hospitals in the Netherlands PARTICIPANTS: Stroke patients (N=344; mean age 66.9+/-12.3y). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The presence of clinical depressive symptoms was determined with the Depression subscale of the Hospital Anxiety and Depression Scale two months post stroke. Psychological factors assessed were: extraversion, neuroticism, optimism, pessimism, self-efficacy, helplessness, acceptance, perceiving benefits, proactive coping, and passive coping. RESULTS: Bivariate correlations and multivariate backward logistic regression were used to analyse associations between psychological factors and post-stroke depressive symptoms, accounting for demographic and stroke-related factors. More neuroticism, pessimism, passive coping, and helplessness, and less extraversion, optimism, self-efficacy, acceptance, perceived benefits, and proactive coping were bivariately associated with the presence of depressive symptoms. Multivariate logistic regression analysis showed that more helplessness (OR 1.17) and passive coping (OR 1.19) and less acceptance (OR 0.89) and perceived benefits (OR 0.89) were independently significantly associated with the presence of post-stroke depressive symptoms (Nagelkerke R-Square 0.49). CONCLUSION: We found a relationship between psychological variables and the presence of depressive symptoms two months post stroke. It is important to take these factors into account during post-stroke rehabilitation.