Objectives:

Depression is a risk factor for stroke. There is a knowledge gap on the predictors of prestroke depression in stroke survivors living in low- and middle-income countries (LMICs). We estimated prevalence and predictors of prestroke depression, as well as its association with poststroke depression (PSD) in the largest study of stroke in Africa.

Methods:

We evaluated information collected as part of the Stroke Investigative Research and Education Network (SIREN) study, a multicentre, case-control study conducted at 15 sites in Ghana and Nigeria. Prestroke depression status was ascertained in stroke survivors using a validated self-report tool, while PSD was assessed using a stroke specific screening tool for depression (“HRQOLISP-E”). Independent associations were investigated using complementary log-log regression and binary logit models.

Results:

Among 1,977 participants, prestroke depression was found in 141 (7.1%). In multivariate analyses, prestroke depression was significantly associated with tachycardia (OR = 2.22, 95% CI = 1.37-3.56) and low consumption of green leafy vegetables (OR = 1.91, 95% CI = 1.12-3.24). Forty-one (29.1%) of the prestroke depression sub-sample developed PSD. However, prestroke depression was not significantly associated with PSD.

Conclusion:

The findings should energize before-the-stroke identification and prioritization of limited treatment resources in LMICs to persons with depression who have multiple, additional, risks of stroke.

中文翻译：

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加纳和尼日利亚的卒中前抑郁症：患病率、预测因素和与卒中后抑郁症的关联

目标：

抑郁症是中风的危险因素。生活在低收入和中等收入国家 (LMIC) 的中风幸存者中风前抑郁的预测因素存在知识差距。我们在非洲最大的卒中研究中评估了卒中前抑郁症的患病率和预测因素，以及它与卒中后抑郁症 (PSD) 的关联。

方法：

我们评估了作为中风调查研究和教育网络 (SIREN) 研究的一部分收集的信息，该研究是在加纳和尼日利亚的 15 个地点进行的多中心病例对照研究。使用经过验证的自我报告工具确定中风幸存者的中风前抑郁状态，而使用中风特定抑郁症筛查工具（“HRQOLISP-E”）评估 PSD。使用互补对数-对数回归和二元对数模型对独立关联进行了调查。

结果：

在 1,977 名参与者中，有 141 人 (7.1%) 患有中风前抑郁症。在多变量分析中，卒中前抑郁与心动过速 (OR = 2.22, 95% CI = 1.37-3.56) 和绿叶蔬菜摄入量低 (OR = 1.91, 95% CI = 1.12-3.24) 显着相关。四十一个 (29.1%) 的卒中前抑郁子样本发展为 PSD。然而，卒中前抑郁与 PSD 无显着相关性。

结论：

研究结果应激发中风前识别，并将 LMIC 中有限的治疗资源优先用于有多种额外中风风险的抑郁症患者。