Prevalence of depression and associated factors among caregivers of stroke survivors in developing countries: A systematic review and meta-analysis

Abstract

Background

Stroke is a leading cause of death and disability worldwide. While caregivers play a vital role in recovery, their long-term support can affect their mental well-being. This study aims to estimate the pooled prevalence of depression and associated factors among caregivers of stroke survivors in developing countries.

Method

A comprehensive literature search using the preferred reporting items for systematic review and meta-analysis (PRISMA) statement was conducted on Scopus, PsycINFO, EMBASE, Google Scholar, Psychiatry Online, and PubMed/MEDLINE. Data were extracted via a Microsoft Excel spreadsheet and analyzed via STATA version 11.0. Egger regression tests and funnel plot analysis were used to check for publication bias, and the I² statistic was used to evaluate statistical heterogeneity. Sensitivity and subgroup analyses were also conducted to identify potential causes of heterogeneity.

Results

Seventeen articles from 12 different countries were analyzed. The pooled prevalence of depression among caregivers of stroke survivors was 48.75% (95% confidence interval (CI): 38.64– 58.86). However, the prevalence of depression ranged widely from 17.2%–76%, which may be due to the variation in the depression assessment tools used, types of caregivers, and continent. A long duration of caregiving was the only significant factor associated with depression among caregivers of stroke survivors.

Conclusion

The current systematic review and meta-analysis revealed a high prevalence of depression among caregivers of stroke survivors in developing countries. However, there was significant heterogeneity between studies, which could be explained by differences in the depression assessment tools used, types of caregivers, and continents. Factors such as long caregiving times were significantly associated with depression among caregivers of stroke survivors. The study suggests that the depression assessment tool utilized itself could have modified the prevalence of depression among caregivers of stroke survivors. Therefore, a single depression assessment tool needs to be authorized.