Severe depression was the strongest predictor of poor quality of life in Iraqi stroke survivors, explaining 31% of variance, alongside anxiety and socio-demographic factors.
Iraqi stroke survivors experience high levels of anxiety and depression, which are strong predictors of poor quality of life, highlighting the need for early psychological assessment and management.
Introduction Stroke affects patients’ physical, psychological, and social well-being, with many survivors suffering anxiety, depression, and a decline in quality of life (QOL). These problems remain underexplored among Middle Eastern populations. Objectives This study aimed to assess levels of stroke-related anxiety, depression, and QOL, as well as to determine their associated factors and predictors among Iraqi patients with stroke. Methods A cross-sectional descriptive correlational design was used, employing the Stroke-Specific Quality of Life (SS-QOL) scale and Hospital Anxiety and Depression Scale on 200 Iraqi stroke survivors. Results The sample consisted of middle-aged and older adults, with a mean age of 58.3 years and 42% of participants aged 65 or above; 52.5% were male. Clinically significant levels of anxiety and depression were reported, with a mean score of 12.2 (SD = 3.4) for anxiety, and 11.46 (SD = 3.45) for depression. Higher risk was observed in older, unmarried, unemployed patients and those in early or intermediate stages since stroke onset. Levels of QOL poorly declined poststroke and were below the theoretical mid-range levels of SS-QOL, with mean SS-QOL = 82.6 (SD = 30.2; range = 49–129). Predictor variables of poor QOL included advanced age ( B = −0.647, p < .001), unmarried status ( B = −5.85, p < .01), hypertension ( B = −4.73, p < .05), early post-stroke stage vs chronic ( B = −19.8, p < .001), intermediate vs chronic stage ( B = −11.3, p < .001), and clinically significant levels of anxiety ( B = −6.61, p < .01) and depression ( B = −23.6, p < .001). Together, these predictors explained 87% of the variance in QOL (adjusted R 2 = .874, F (18,181) = 77.5, p < .001). Severe depression emerged as the strongest predictor, accounting for 31% of variance ( t (181) = −23.6, p < .001; sr 2 = .310). Conclusions Iraqi stroke survivors experience severe levels of anxiety and depression, consistent with poor QOL, and are influenced by socio-demographic and clinical factors. Early assessment and targeted management of high-risk groups by healthcare providers should be considered with the objective of optimizing recovery and rehabilitation. Depression is of great clinical importance due to its significant impact on QOL.
Ayasrah et al. (2026) studied this question. Severe depression was the strongest predictor of poor quality of life in Iraqi stroke survivors, explaining 31% of variance, alongside anxiety and socio-demographic factors.