Early detection of patients at risk for anxiety, depression and apathy after stroke

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• 作者：Ulrike Sagen ; Arnstein Finset ; Torbjø ; rn Moum ; Tore Mø ; rl ; Tom Gunnar Vik ; Tibor Nagy ; Toril Dammen
• 关键词：Anxiety ; Apathy ; Depression ; Stroke management ; Assessment
• 刊名：General Hospital Psychiatry
• 出版年：2010
• 出版时间：January-February 2010
• 年：2010
• 卷：32
• 期：1
• 页码：80-85
• 全文大小：156 K

文摘

Background and purpose

The aim of this study was to identify clinical factors in the acute stage that can predict anxiety, depression and apathy at 4 months after stroke.

Methods

One hundred four consecutive stroke patients in a stroke unit were assessed within the first 2 weeks and after 4 months. Assessments included anxiety and depression symptoms on the Hospital Anxiety and Depression Scale (HADS) [HADS Anxiety subscale (HADS-A) ≥8 and HADS Depression subscale (HADS-D) ≥8], physical impairment, functional disability, somatic comorbidity upon admission, assessment of apathy (score ≥34 on the Apathy Evaluation Scale) and a psychiatric Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of anxiety disorder (anxiety) or depression (depression) on follow-up. Logistic regression analysis was used to identify factors associated with anxiety, depression and apathy.

Results

Anxiety and depression at 4 months were significantly associated with HADS-A scores of ≥8 upon admission [odds ratio (OR)=4.4; 95 % confidence interval (95 % CI)=1.7–11.9; P=.003 and OR=2.9; 95 % CI=1.0–7.9; P=.043, respectively]. Apathy at 4 months was significantly associated with somatic comorbidity upon admission (OR=3.0; 95 % CI=1.0–8.3; P=.036) and had a borderline association with HADS-D scores of ≥8 (OR=8.4; 95 % CI=1.0–72.0; P=.051) upon admission.

Conclusion

Assessment with HADS within the first 2 weeks of stroke can contribute to the detection of patients at risk for clinically significant anxiety, depression and apathy at 4 months after stroke.