B-97: The Role of Psychosocial Vulnerabilities and Stroke Laterality in Predicting Post-Stroke Depression

Abstract

Objective: This study examined the role of stroke laterality and psychosocial vulnerabilities in predicting post-stroke depression (PSD), controlling for pre-existing depressive symptoms. Method/Data Selection: Participants (N = 51) were primarily male (58.8%), Caucasian (90.2%) older adults (M = 63.69 years, SD = 15.20) who received mechanical thrombectomy (MT) following acute ischemic stroke and were consecutively recruited for a longitudinal study. At 90-day follow-up, pre-existing depressive symptoms were assessed using the Patient Health Questionnaire-2 (PHQ-2) and stroke laterality was determined through medical chart review. The PHQ-2 was re-administered at 4-6–month follow-up to measure PSD, with 19.6% screening positive. Perceived stress and social isolation were assessed using the Institute of Medicine’s recommended social and behavioral measures. Results/Data Synthesis: Hierarchical logistic regression indicated pre-stroke depression did not significantly predict PSD, X^2(1) = 1.92, p = .166. The addition of stroke laterality to the model also did not significantly predict PSD, X^2(2) = 2.41, p = .299. The final model, including perceived stress and social isolation, was significant, X^2(4) = 25.68, p < .001, and accounted for 64.1% of the variance in PSD, Nagelkerke R^2 = .641. This model correctly classified 89.8% of cases. Perceived stress was a significant predictor of PSD, OR = 9.95, 95% CI [2.14, 46.22], p = .003. Conclusions: Pre-stroke depression and stroke laterality did not predict PSD while psychosocial vulnerabilities, particularly perceived stress, predicted PSD beyond stroke laterality and pre-existing depressive symptoms. Findings suggest the importance of psychosocial assessment in MT-treated stroke survivors, though further research with a larger sample is needed to clarify contributions of individual predictors.