Frequency, Risk Factors, Sex Differences, and Predictors of Post-Stroke Depression: A Multicenter Upper Egypt Study

Background: Post-stroke depression (PSD) is the most common neuropsychiatric complication following a stroke. Objectives: This study investigated PSD frequency, associated risk factors, sex-specific differences, and predictors of PSD.Methods: The study comprised a cohort of 370 individuals who were diagnosed with acute stroke. Patients underwent clinical evaluations, vascular risk factor analysis, stroke severity measurement (Scandinavian Stroke Scale), cognitive assessment (Mini-Mental State Examination), brain imaging, and depression screening (Hamilton Depression Rating Scale) at baseline and at six months. Functional outcomes were evaluated using the Barthel Index.Results: PSD was observed in 28.7% of cases and was significantly associated with unmarried status, hypertension, diabetes, and obesity. PSD patients exhibited more severe neurological deficits and showed higher rates of Middle cerebral artery occlusions, small vessel disease, and bilateral lesions. Multivariate analysis identified hypertension, stroke recurrence, bilateral brain lesions, lower cognitive function, increased triglyceride levels, smoking, and specific neurological manifestations as independent risk factors for PSD. Gender differences were noted in sociodemographic factors but did not significantly affect outcomes.Conclusion: PSD is prevalent, with potential key predictors including bilateral brain lesions, reduced cognitive function, and stroke recurrence. Findings emphasize the importance of early risk assessment and gender-sensitive approaches to PSD management.