Post-stroke Depression Among Stroke Survivors in the Acute Stroke Phase

<p><strong>Purpose:</strong> The purpose of this study is to describe relationships between sociodemographics, clinical characteristics, length of stay, depression screening (Patient Health Questionnaire-2 [PHQ-2] or Patient Health Questionnaire-9 [PHQ-9]) and the likelihood of post-stroke depression diagnosis among inpatient stroke cases in Northern California. </p> <p><strong>Background:</strong> Current depression screening instruments, which were originally designed for the primary care setting, are being used in the acute stroke setting. Post-stroke depression is often underdiagnosed and can lead to poor stroke outcomes. This study looked at the effectiveness of such instruments in detecting post-stroke depression when administered in the inpatient setting during the acute stroke phase while considering sociodemographic and clinical characteristics.</p> <p><strong>Methods:</strong> Using electronic health record case reviews, this retrospective cross-sectional design described the relationships between select patient sociodemographics, clinical characteristics, and use of the PHQ-2 and PHQ-9 instruments in detecting post-stroke depression. Descriptive statistics characterized the sample and tests of association described the relationships between the variables. Binomial logistic regression was done to describe the likelihood of post-stroke depression diagnosis (yes, no) accounted for by select sociodemographics, clinical characteristics, and use of PHQ-2 and PHQ-9 depression screening instruments.</p> <p><strong>Results:</strong> Site of where stroke care was received, history of depression, presence of heart failure, marital status of divorced/separated, as well as the use of PHQ-2 (regardless of score), were associated with the presence of post-stroke depression.</p> <p><strong>Implications for Research:</strong> Future studies need to explore the development of a screening instrument designed specifically for post-stroke depression.</p> <p><strong>Conclusion:</strong> Acute stroke patients with a comorbidity of heart failure, history of depression, are divorced or separated, should be considered as those with a high risk of developing post-stroke depression. Early screening and follow-up must be established to mitigate the risk of underdiagnosing post-stroke depression which can result in sub-optimal or poor stroke care outcomes. In addition, the use of the well-known PHQ-2 and PHQ-9 instruments are not sensitive in detecting post-stroke depression in the acute stroke phase.</p>

Name thesis:degree_name

PhD Nursing

Level thesis:degree_level

Dissertation: USD Users Only

Discipline thesis:degree_discipline

Nursing

Year dc:date.available

2026

Author dc:creator

• Shahwan Solorzano, Sheryn

• Stroke
• depression
• depression screening
• health-related quality of life
• acute care
• Behavioral Medicine
• Critical Care Nursing
• Mental and Social Health
• Neurology
• Neurosurgery
• Other Nursing
• Psychiatric and Mental Health Nursing
• Psychology

Repository record dc:identifier

https://digital.sandiego.edu/dissertations/1107

OAI identifier oai:identifier

oai:digital.sandiego.edu:dissertations-2125