Stroke Survivors Have Almost Three Times Higher Risk of Depression; A Systematic Review and Meta-Analysis

Background: Post-stroke depression (PSD) is one of the most frequent and important complications following stroke that adversely conditions functional recovery and patient’s quality of life. Meanwhile the prevalence proportion of PSD has been widely documented, ranging from 20 till 60%, the relationship between stroke and the manifestation of PSD, quantified with the odds ratio (OR), has been less explored. The primary aim of this meta-analysis is to determine prevalence odds ratio of suffering depression in stroke survivors. Prevalence proportion of PSD was also analyzed as a secondary aim. Methods: A pre-registered meta-analysis designed based on Prisma guidelines with searches from inception to 2024 September 23 was carried out on PubMed and Web of Science databases. Studies reporting the prevalence OR associated with PSD manifestation were eligible for inclusion to achieve the primary aim. Twenty-four comparative studies, including a total population of 947617 people, met the inclusion criteria. PSD prevalence proportion was extracted from 193 articles, including 484846 stroke patients. Quality assessments were performed using the Newcastle-Ottawa scale (NOS). Data were meta-analyzed using random effects model. Results: Compared with control population, stroke survivals had higher odds of developing PSD (OR: 2.81; 95% CI: 2.36-3.35). Prevalence of PSD was 32.15% ± 15.81. Conclusions: Stroke survivals have almost 3 times higher probability of suffering depression after stroke than the general population and almost one third of stroke patients will suffer PSD.