ABSTRACT NUMBER: ESOC2026A1774 IS STROKE-RELATED PHYSICAL IMPAIRMENT A CONFOUNDING FACTOR IN DEPRESSION SCREENING TOOLS

Abstract Background and aims Depression is seen with a frequency of around 30% after stroke, but its assessment is carried out on stroke-related physical impairments and somatic features of depression. It remains unclear whether functional deficits systematically inflate scores on widely used depression screening tools. The aim of this study was to investigate whether patients physically affected by stroke tend to score higher on the activity-, energy-, and worry-related items on depression screening scales. Methods This retrospective cohort study included 184 patients from two stroke cohorts recruited within one week of stroke onset. Neurological function and functional independence were assessed with the National Institutes of Health Stroke Scale (NIHSS) and the Barthel Index. Depressive symptoms were measured using the 6-item version of Hamilton Depression Rating Scale (HAM-D6), the Hospital Anxiety and Depression Scale (HADS), and the Major Depression Inventory (MDI). Items related to activity, energy, and worrying were predefined and analysed. General linear models assessed associations between functional measures and both item-specific and total depression scores at baseline and follow-up. Results Across cohorts, some significant correlations were observed between motor deficits and activity-related items, but these associations were inconsistent across scales and time points. Energy- and worry-related items showed few and inconsistent associations with functional measures. Conclusions Physical impairments after stroke show only subtle and inconsistent associations with specific depression-scale items, suggesting that common screening tools are not systematically biased by stroke-related functional deficits or by patients’ perceived energy and worry. Further research in larger and more homogeneous cohorts is warranted. Conflict of interest Nothing to disclose