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Acute post stroke depression at a Primary Stroke Center in the Middle East

journal contribution
submitted on 2024-03-03, 09:51 and posted on 2024-03-03, 12:04 authored by Stacy Schantz Wilkins, Naveed Akhtar, Abdul Salam, Paula Bourke, Sujatha Joseph, Mark Santos, Ashfaq Shuaib


Depression occurs in approximately 30 percent of stroke patients, leading to increased disability, lower quality of life and increased mortality. Given new recommendations to assess depression in acute stroke patients this study evaluated rates of acute post stroke depression at a Primary Stroke Center in Doha, Qatar.


Acute stroke patients (n = 233) were given the PHQ-9 and the Mini-Cog test by stroke unit nurses within the first few days post stroke. This was part of a clinical improvement project conducted from March 2016 thru March 2017.


Approximately 20% of acute post stroke patients (46/233) scored in the moderately depressed range on the Patient Health Questionnaire (PHQ-9 ≥10 with item 1 and/or 2 endorsed). Nationality and dysarthria were significantly associated with depression. Females were twice as likely to be depressed. A significantly greater number of Middle Eastern and African patients were depressed (30.18%) than Southeast Asian and Western Pacific patients (16.76%). A PHQ-2 cut off of 2 was optimal with sensitivity of 91.3 and specificity of 71.6.


Almost 20% of acute stroke patients were moderately depressed on the PHQ-9, with Middle Eastern/African patients almost twice as likely to be depressed. This may reflect higher baseline pre-stroke depression levels in those of Middle Eastern/African background, perhaps due to greater levels or stress or trauma exposure in these groups. Dysarthria was found to be significantly associated with depression. Initial screening with the PHQ-2 using a cut-off of 2 (versus the cut-off of 3 used in primary care settings) may be beneficial. Based on these results acute post stroke depression screening is recommended in the Middle East, coupled with culturally sensitive psychiatric care.

Other Information

Published in: PLOS ONE
See article on publisher's website:


Open Access funding provided by the Qatar National Library.



  • English


Public Library of Science (PLoS)

Publication Year

  • 2018

License statement

This Item is licensed under the Creative Commons Attribution CC0 1.0 Universal Public Domain Dedication International License.

Institution affiliated with

  • Hamad Medical Corporation
  • Academic Health System - HMC
  • Neuroscience Institute - HMC

Geographic coverage