Background: A third of all strokes occurs in people under the age of 65 years. Return to Work represents a main goal in the rehabilitation of this group and therefore, may reduce the risk depression after stroke. We investigated the effect of Return to Work within the first year after stroke while controlling for established risk factors of post-stroke depression.
Methods: People with ischemic stroke were consecutively recruited from two German inpatient rehabilitation clinics and followed-up six and twelve months later. Assessments included demographic, stroke-related and psychological variables. Within the subsample of participants below age 65 (n = 158), multiple linear regression analyses were used to predict depressive symptoms as measured by the Geriatric Depression Scale at two follow-ups (6 and 12M-FU).
Results: At 6M-FU, 22 out of 89 (13.9%) participants were back at work. Depressive symptoms at 6M-FU were predicted by pre-stroke depression (β = .24), social support (β = -.35), and current employment status (β = .39, all p < .05). At 12M-FU, 34 out of 95 (21.5%) were back at work. Depressive symptoms at 12M-FU were predicted by pre-stroke depression (β = .30), social support (β = -.29), stroke severity (β = .19), and current employment status (β = -.24, all p < .05). 
Discussion: Return to Work may represent a protective factor of depression within the first year after stroke. These results emphasize the importance of vocational rehabilitation for mental health in younger people with stroke.

RETURN TO WORK AS A PROTECTIVE FACTOR OF DEPRESSION AFTER STROKE