Post-Stroke Depression and Serum High Sensitivity C-Reactive Protein among the Acute Stroke Population of a Teaching Hospital in Ilorin, Nigeria

Mumeen Olaitan Salihu^1, , Olatunji A. Abiodun², Peter Omoniyi Ajiboye², Kolawole Wasiu Wahab³ and Alfred Bamiso Makanjuola²

¹Department of Behavioural Sciences, University of Ilorin Teaching Hospital, Ilorin, Nigeria

²Department of Behavioural Sciences, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria

³Department of Internal Medicine, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria

Cite this paper:
Mumeen Olaitan Salihu, Olatunji A. Abiodun, Peter Omoniyi Ajiboye, Kolawole Wasiu Wahab and Alfred Bamiso Makanjuola. Post-Stroke Depression and Serum High Sensitivity C-Reactive Protein among the Acute Stroke Population of a Teaching Hospital in Ilorin, Nigeria. American Journal of Medical Sciences and Medicine. 2023; 11(2):55-63. doi: 10.12691/ajmsm-11-2-3

Abstract

Background: The association between post-stroke depression (PSD) and inflammatory markers has been investigated, but the results were conflicting. We aim to explore the relationship between post-stroke depression (PSD) and high sensitivity C-Reactive Protein (hs-CRP) in a stroke population at the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Subjects and Method: Ninety patients admitted within 72 hours of their first-ever acute stroke were consecutively recruited and followed up for 3 months. They were age- and gender-matched with 90 stroke-free controls. Serum levels of hs-CRP were measured at admission and the first interview in the study and control groups. In both groups, depression and its severity were assessed using the Mini International Neuropsychiatric Interview (MINI) Plus and Hamilton Depression (HAM-D) scales. The National Institutes of Health Stroke-Scale (NIHSS) and Modified Rankin Scale (mRS) were used to assess stroke severity and functional disability. Results: The median ages of stroke patients and controls were 59 (IQR, 51⎼70) and 60 (IQR, 52⎼65) years, respectively. PSD was present in 22.2% of cases compared to 10.0% in controls (p= 0.026). There was no significant difference between serum hs-CRP levels in patients with PSD and those without depression (19.35 [IQR, 12.98–23.38] mg/L vs. 18.50 [IQR, 14.3–20.93] mg/L, P=0.694). Factors associated with PSD included stroke severity at admission (χ²= 11.480; p=0.001) and perceived poor social support (χ²= 8.889; p=0.003). However, stroke severity was the only independent predictor of PSD with an adjusted OR of 7.568 (95%CI, 1.874⎼30.566; p= 0.004). Conclusion: Our patients have a high frequency of PSD, independently associated with stroke severity. Focused rehabilitation of those at risk of PSD is encouraged to reduce its burden.

Keywords:
acute stroke high sensitivity C-reactive protein Nigeria post-stroke depression UITH

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