Prevalence of Depressive Symptoms and Associated Factors Among Adult Stroke Survivors in the Subacute and Chronic Phases: A Scoping Review

PURPOSE: This review synthesized the prevalence and factors associated with depressive symptoms among adult stroke survivors during the subacute and chronic phases. DESIGN: A scoping review. METHODS: Research articles in English published up to November 2024 were identified through PubMed and CINAHL searches, following Arksey & O'Malley's methodological framework. RESULTS: Fourteen studies were included from 609 screened. Various instruments were used to assess depressive symptoms, with prevalence estimates varying from 20% to 84.8%. Several clinical and psychosocial factors were associated with higher levels of depressive symptoms, including comorbid conditions, greater functional dependence, stroke severity, and perceived stigma. In contrast, post-stroke employment, optimism, and social support were associated with lower levels of depressive symptoms. Caregiver well-being was also closely linked to depressive symptoms among adult stroke survivors. CONCLUSIONS: Our findings highlight variation in prevalence and factors associated with depressive symptoms among adult stroke survivors during the subacute and chronic stages. Effective management should consider patients' clinical and psychosocial conditions as well as caregiver well-being. CLINICAL RELEVANCE: Brief standardized tools may support routine and repeated screening for depressive symptoms in nursing practice during ongoing rehabilitation and follow-up care. Screening for caregiver distress may also be important in stroke care.