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Year : 2022  |  Volume : 9  |  Issue : 2  |  Page : 93-99

Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India

1 Department of Psychiatry, Dharwad Institute of Mental Health and Neurosciences, Dharwad; Department of Neurology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
2 Department of Neurology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
3 Department of Psychiatry, Geriatric Psychiatry Unit, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Saraswathi Nagaraju
Department of Psychiatry, Dharwad Institute of Mental Health and Neurosciences Dharwad - 580 008, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jgmh.jgmh_47_22

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Background: Post-stroke depression (PSD) is seen in up to 35% of stroke survivors, contributing to morbidity and caregiver burden, that could deter the acute and rehabilitation treatment. Depression in stroke contributes to more disability and caregiver burden. Understanding coping methods of caregivers in PSD results in better caregiving, reduces stress and improves family relationships. There is paucity of studies examining PSD and its determinants in Indian context. Objectives: The objective is to study the association of PSD with disability, with caregiver burden, and coping methods adopted by the caregivers. Methods: Consenting participants (and their caregivers) attending Neurology outpatients with the first episode of Stroke (N=226) in a tertiary care center in a tier 2 city in South India, with 56% participants from rural background, were evaluated between three and six months of stroke. Two groups namely PSD (n = 67) and post-stroke without depression (PSwD, n = 159) based on cutoff score of 9/10 on a valid Hamilton Depression Rating Scale were compared for their demographics, social, physical, and functional factors. Barthel Disability Index (BDI) for disability, Zarit Burden Interview (ZBI) for caregiver burden and coping checklist (CCL) by Rao et al. on caregivers particularly prepared for studying in the Indian context were also administered. Results: The rate of PSD was found to be 29.6%. PSD group were older and had relatively more common in females (p < 0.001). The type of stroke and site of vascular lesion were not associated with PSD (p = 0.68 and p = 0.24). Stroke severity scores were higher in PSD group (p < 0.001). Disability as per BDI scores was greater in PSD group against PSwD group (p < 0.001). ZBI scores show greater caregiver burden in PSD group than PSwD (p < 0.001). Measures were significantly higher in all CCL sub-categories in caregivers of PSD group compared with PSwD. Conclusion: PSD prevalence of close to one third in stroke survivors, with female gender, older age, stroke severity, and functional disability as its key determinants. Furthermore, the PSD was significantly associated with caregiver burden and study also found preferred coping methods were adopted by caregivers of PSD group. Early identification and treatment of PSD is of utmost important to minimize disability, reduce caregiver burden and improvise coping methods.

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