Han Z, Zhang DD, Li NN. Influencing factors and construction of a nomogram for post-stroke depression in patients with chronic stroke. World J Psychiatry 2025; 15(11): 108688 [DOI: 10.5498/wjp.v15.i11.108688]
Corresponding Author of This Article
Ni-Ni Li, Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Youyi Road, Xi’an 710068, Shaanxi Province, China. lnn18700865726@sina.com
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Psychology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 19, 2025 (publication date) through Nov 4, 2025
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World Journal of Psychiatry
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2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Han Z, Zhang DD, Li NN. Influencing factors and construction of a nomogram for post-stroke depression in patients with chronic stroke. World J Psychiatry 2025; 15(11): 108688 [DOI: 10.5498/wjp.v15.i11.108688]
World J Psychiatry. Nov 19, 2025; 15(11): 108688 Published online Nov 19, 2025. doi: 10.5498/wjp.v15.i11.108688
Influencing factors and construction of a nomogram for post-stroke depression in patients with chronic stroke
Zheng Han, Dong-Dong Zhang, Ni-Ni Li
Zheng Han, Ni-Ni Li, Department of Neurology, Shaanxi Provincial People's Hospital, Xi’an 710068, Shaanxi Province, China
Dong-Dong Zhang, Department of Neurosurgery, Norinco General Hospital, Xi’an 710065, Shaanxi Province, China
Author contributions: Han Z contributed to conceptualization, methodology, data statistics and analysis, writing-original draft preparation, and review of the manuscript.; Han Z and Zhang DD contributed to case collection and collation; Li NN contributed to supervision.
Institutional review board statement: This study was approved by the Ethics Committee of Shaanxi Provincial People's Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ni-Ni Li, Department of Neurology, Shaanxi Provincial People's Hospital, No. 256 West Youyi Road, Xi’an 710068, Shaanxi Province, China. lnn18700865726@sina.com
Received: June 17, 2025 Revised: August 7, 2025 Accepted: September 2, 2025 Published online: November 19, 2025 Processing time: 139 Days and 17.5 Hours
Abstract
BACKGROUND
Post-stroke depression (PSD), a condition commonly developed in patients with chronic stroke, impairs both functional rehabilitation and daily living.
AIM
To comprehensively analyze PSD contributors in chronic phase stroke and construct a precise nomogram.
METHODS
Two hundred patients with chronic stroke admitted in over 7 years (January 2017 to January 2024), were enrolled and categorized into the PSD group (n = 96) and the non-PSD (NPSD) group (n = 104). Demographic characteristics, clinicopathological data, and biochemical indicators were collected and analyzed by univariate analysis. Significant predictors identified in the univariate analysis were subsequently incorporated into a binary logistic regression model to assess their independent effects on PSD risk. The discriminative ability/calibration of the developed PSD prediction nomogram was assessed.
RESULTS
Compared with the NPSD group, the PSD group included a higher proportion of patients aged ≥ 60 years, divorced/widowed, with an education level below senior high school, presenting with ≥ 2 comorbidities, exhibiting severe neurological impairment, and having multiple lesions. Additionally, the PSD group showed significantly higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) than the NPSD group. After assigning values to significant predictors, multivariate analysis indicated that educational level (P = 0.046), NLR (P < 0.001), and PLR (P < 0.001) were independently associated with PSD in patients with chronic stroke. The developed nomogram exhibited favorable discrimination performance. The nomogram's calibration remained accurate for high-risk stratification but displayed modest inconsistencies in low- and middle-risk categories.
CONCLUSION
Education level, NLR, and PLR independently contribute to PSD in patients with chronic stroke. The constructed nomogram effectively predicts PSD risk within the range of 0.10-0.90, presenting a valuable tool for clinical monitoring and risk assessment of PSD in patients with chronic stroke.
Core Tip: This study centers on identifying contributors to post-stroke depression (PSD) in patients with chronic stroke and establishing a relevant nomogram. Based on the results of various analytical procedures, individuals with lower educational attainment, and high neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are at greater risk of PSD. Tailored clinical interventions, along with vigilant monitoring, can effectively mitigate PSD risk in patients presenting these features. The nomogram shows strong predictive accuracy for high-risk groups; however, its reliability slightly decreases for low- and intermediate-risk groups.
