Background/aims:
Grief after stroke is largely overlooked in both research and clinical practice. Sudden loss of independence, roles, identity, and future may precipitate a distinct form of grief. Although related to depression, evidence from non-stroke populations suggests that grief and depression are distinct conditions requiring different management. This study examined the association between depressive symptoms and grief post-stroke.
Methods:
We conducted an observational cohort study of stroke survivors from two rehabilitation centres in Victoria and South Australia. Participants completed the Spinal Cord Injury—Quality of Life (SCI-QoL) Grief and Loss measure adapted for stroke, and the Hospital Anxiety and Depression Scale (HADS) between 1–12 months post-stroke. Associations between grief and depressive symptoms were analysed using Spearman’s correlation, Mann–Whitney U, and Fisher’s exact tests.
Results:
Thirty-two stroke survivors were included (18 [56%] male; median age 56 years, IQR 45.5–62.5). Most had ischaemic stroke (n=26, 81%). Ten (31%) reported clinically significant depressive symptoms (HADS-D≥8) and 14 (44%) had elevated grief (SCI-QoL T-scores above the SCI population mean). Depression and grief scores were positively associated (Spearman ρ=0.58, p<0.001). Participants with depressive symptoms had higher grief scores (median 55.9, IQR 10.7) than those without (median 46.2, IQR 12; p<0.003). Grief frequently co-occurred with depression (8/10 cases) but also occurred in participants without depression (5/22, p=0.005).
Conclusion:
Grief was common post-stroke and occurred both with and without depression, highlighting grief as a distinct and clinically relevant aspect of post-stroke recovery. These findings support further research into post-stroke grief and suggest potential clinical implications, including tailored management strategies.