Factors Associated With Poststroke Depression in Stroke Survivors: Findings From the Korea National Health and Nutrition Examination Survey

BACKGROUND: Stroke is a global health issue causing significant physical and mental suffering and increased healthcare costs. Depression affects 11% to 80% of stroke survivors, yet mental health consequences and their complex correlates receive less attention. OBJECTIVE: In this study, we aimed to investigate the biophysical, psychological, and social factors influencing depression in stroke survivors. METHODS: This study employed a cross-sectional, correlational design using data from the 2014, 2016, 2018, and 2020 Korea National Health and Nutrition Examination Surveys. We included respondents aged 19 or older diagnosed with stroke by a physician. Depression was assessed using the Patient Health Questionnaire-9; scores of 10 or above indicated poststroke depression. Biophysical (eg, age and high-sensitivity C-reactive protein [hs-CRP] levels measured only in 2016 and 2018), psychological (eg, perceived stress), and social factors (eg, income and household size) were assessed. Complex sample logistic regression was used to analyze factors associated with poststroke depression. RESULTS: The sample included 475 individuals; 14.6% had poststroke depression. Participants with activity limitations (odds ratio [OR]: 3.07; 95% confidence interval [CI]: 1.33-7.12), diabetes (OR: 2.70; 95% CI: 1.09-6.69), high stress (OR: 13.96; 95% CI: 6.92-28.15), and poor health perception (OR: 3.40; 95% CI: 1.18-9.79) had increased odds of poststroke depression. In a subgroup analysis (n = 220), elevated hs-CRP levels increased depression risk nearly 3-fold (OR: 2.92; 95% CI: 1.02-8.38). CONCLUSIONS: Poststroke depression is prevalent among Korean stroke survivors. Activity limitations, diabetes, high stress, poorer perceived health, and elevated hs-CRP levels were associated with depression.