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Depression and Anxiety Across the First Year After Ischemic Stroke: Findings from a Population-Based New Zealand ARCOS-IV Study

  • Suzanne Barker-Collo (a1), Rita Krishnamurthi (a2), Emma Witt (a3), Alice Theadom (a2), Nicola Starkey (a4), P. Alan Barber (a5), Derrick Bennett (a6), Elaine Rush (a7), Bruce Arroll (a8) and Valery Feigin (a2)...

Abstract

Background: Depression and anxiety are the two most frequently studied emotional outcomes of stroke. However, few previous studies have been carried out at a population level or beyond 6 months post stroke. The aim of this study was to describe depression and anxiety across the first year following incident ischemic stroke (IS), and identify predictive factors in a population-based study.

Method: The Hospital Anxiety Depression Scale (HADS) was administered at baseline (within 2 weeks of onset), and again at 1-month, 6-months and 12-months after IS in a sample (N = 365) drawn from a population-based study.

Results: Over 75% of those assessed experienced depression or anxiety symptoms below cut-offs for probable disorder across the year post stroke. Moderate to severe symptoms for anxiety were approximately twice as likely (range 4.1%–10.6%) as compared to depression (range 2.5%–5.0%) at each assessment. The greatest improvement in anxiety occurred within the first month post stroke. In contrast, the greatest reduction in depression occurred between 1- to 6-months post stroke.

Conclusions: Anxiety symptoms in the moderate to severe range were twice as common as depression, and improved over the first month post stroke, whilst depression symptoms persisted for up to 6 months, indicating a need to target these two issues at different points in the recovery process.

Copyright

Corresponding author

Address for correspondence: Suzanne Barker-Collo, PhD, Associate Professor, School of Psychology, The University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail: s.barker-collo@auckland.ac.nz

References

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Aben, I., Verhey, F., Strik, J., Lousberg, R., Lodder, J., & Honig, A. (2003). A comparative study into the one year cumulative incidence of depression after stroke and myocardial infarction. Journal of Neurology, Neurosurgery & Psychiatry, 74 (5), 581585.
Aho, K., Harmsen, P., Hatano, S., Marquardsen, J., Smirnov, V.E., & Strasser, T. (1980). Cerebrovascular disease in the community: Results of a WHO collaborative study. Bulletin of the World Health Organisation, 58, 113130.
Angelelli, P., Paolucci, S., Bivona, U., Piccardi, L., Ciurli, P., & Cantagallo, A. (2004). Development of neuopsychiatric symptoms in post-stroke patients: A cross-sectional study. Acta Psychiatrica Scandinavica, 110, 5563.
Åstrom, M., Adolfsson, R., & Asplund, K. (1993). Major depression in stroke patients: A 3-year longitudinal study. Stroke, 24, 976982.
Ayerbe, L., Ayis, S., & Wolfe, C. (2013). Natural history, predictors, and outcomes of depression after stroke: A systematic review and meta-analysis. British Journal of Psychiatry, 202, 1421.
Barker-Collo, S.L. (2007). Depression and anxiety 3 months post stroke: Prevalence and correlates. Archives of Clinical Neuropsychology, 22, 519531.
Bjelland, I., Dahl, A., Haug, T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52 (2), 6977.
Brodaty, H., Withall, A., & Sachdev, P.S. (2007). Rates of depression at 3 and 15 months poststroke and their relationship with cognitive decline: The sydney stroke study. The American Journal of Geriatric Psychiatry, 15, 477486.
Broomfield, N., Quinn, T., Abdul-Rahim, A., Walters, M., & Evans, J. (2014). Depression and anxiety symptoms post-stroke/TIA: Prevalence and associations in cross-sectional data from a regional stroke registry. BMC Neurology, 14, 198206.
Campbell Burton, C.A., Murray, J., Holmes, J., Astin, F., Greenwood, D., & Knapp, P. (2010). Frequency of anxiety after stroke: A systematic review and meta-analysis of observational studies. International Journal of Stroke, 8, 545559.
Carod-Artal, F. (2006). Depresion postictus. Epidemiologia, criterios diagnosticos y factores de riesgo. Reviews in Neurology, 42, 169175.
Dafer, R., Rao, S., Shareef, A., & Sharma, A. (2008). Poststroke depression. Topics in Stroke Rehabilitation, 15, 1321.
De Ryck, A., Brouns, R., & Geurden, M. (2014). Risk factors for poststroke deoression: Identification of inconsistencies based on a systematic review. Journal of Geriatric Psychiatry and Neurology, 27, 147158.
Gilbody, S., Sheldon, T., & House, A. (2008). Screening and case-finding instruments for depression: A meta-analysis. Canadian Medical Association Journal, 178 (8), 9971003.
Granger, C., Dewis, L., Peters, N., Sherwood, C., & Barrett, J. (1979). Stroke rehabilitation: Analysis of repeated Barthel Index measures. Archives of Physical Medicine and Rehabilitation, 60, 1417.
Hackett, M., & Pickles, K. (2014). Part I: Frequency of depression after stroke: An updated systematic review and meta-analysis of observational studies. International Journal of Stroke, 9, 10171025.
Hackett, M., Anderson, C., House, A., & Xia, J. (2008). Interventions for treating depression after stroke. Cochrane Database Systematic Reviews, 8 (4), CD003437.
Hackett, M.L., & Anderson, C.S. (2014). Predictors of depression after stroke. A systematic review of observational studies. Stroke, 36, 22962301.
Health, M.o. (2013). New Zealand health survey: Annual update of key findings 2012/13. Wellington, New Zealand: Ministry of health.
Hsueh, I.-P., Lin, J.-H., Jeng, J.-S., & Hsieh, C.-L. (2002). Comparison of the psychometric characteristics of the functional independence measure, 5 item Barthel Index, and 10 item Barthel Index in patients with stroke. Journal of Neurology, Neurosurgery, and Psychiatry, 73, 188190.
Huybrechts, K.F., & Caro, J.J. (2007). The Barthel Index and modified rankin scale as prognostic tools for long-term outcomes after stroke: A qualitative review of the literature. Current Medical Research and Opinion, 23 (7), 16271636.
Johnson, J., Minarik, P., & Nystrom, K. (2006). Poststroke depression incidence and risk factors: An integrative literature review. Journal of Neuroscience Nursing, 38, 316327.
Kim, J., Lee, E., Chang, D., Park, J., Ahn, S., Cha, J., . . . EMOTION investigators, . (2017). Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: A multicentre, double-blind, randomised, placebo-controlled study. Lancet Psychiatry, 4 (1), 3341.
Kim, J.S. (2016). Post-stroke mood and emotional disturbances: Pharmacological therapy based on mechanisms. Journal of Stroke, 18 (3), 244255.
Krishnamurthi, R., Jones, A., Barber, P., Barker-Collo, S., McPherson, K., & Bennett, D., . . . ARCOS IV Programme Group. (2014). Methodology of a population-based stroke and TIA incidence and outcomes study: The Auckland regional community stroke study (ARCOS IV) 2011–2012. International Journal of Stroke, 9 (1), 140147.
Kutlubaev, M., & Hackett, M. (2014). Part II: Predictors of depression after stroke and impact of depression on stroke outcome: An updated systematic review of observational studies. International Journal of Stroke, 9, 10261036.
Lindén, T., Blomstrand, C., & Skoog, I. (2007). Depressive disorders after 20 months in elderly stroke patients: A case-control study. Stroke, 38 (6), 18601863.
Paolucci, S., Bragoni, M., Coiro, P., De, A.D., Fusco, F.R., Morelli, D., . . . Pratesi, L. (2006). Is sex a prognostic factor in stroke rehabilitation? A matched comparison. Stroke, 37, 29892994.
Robinson, R., & Jorge, R. (2016). Post-stroke depression: A review. American Journal of Psychiatry, 173 (3), 221231.
Sachdev, P.S. (1989). Psychiatric illness in New Zealand Maori. Australia and New Zealand Journal of Psychiatry, 23 (4), 529541.
Schepers, V., Post, M., Visser-Meily, A., van de Port, I., Akhmouch, M., & Lindeman, E. (2009). Prediction of depressive symptoms up to three years post-stroke. Journal of Rehabilitation Medicine, 41, 930935.
Simon, G., & VonKorff, M. (1995). Recognition, management, and outcomes of depression in primary care. Archives of Family Medicine, 4 (2), 99105.
Townend, B., Whyte, S., Desborough, T., Crimmins, D., Markus, R., Levi, C., & Sturm, J. (2007). Longitudinal prevalence and determinants of early mood disorder post-stroke. Journal of Clinical Neuroscience, 14 (5), 429432.
Vataja, R., Leppävuori, A., Pohjasvaara, T., Mäntylä, R., Aronen, H., Salonen, O., . . . Erkinjuntti, T. (2004). Poststroke depression and lesion location revisited. Journal of Neuropsychiatry and Clinical Neuroscience, 16 (2), 156162.
Verdelho, A., Henon, H., & Lebert, F. (2004). Depressive symptoms after stroke and relationship with dementia: A three-year follow-up study. Neurology, 62, 905911.
Whyte, E.M., & Mulsant, B.H. (2002). Post stroke depression: Epidemiology, pathophysiology, and biological treatment. Biological Psychiatry, 52 (3), 253264.
Wilson, J., Hareendran, A., Grant, M., Baird, T., Schulz, U., Muir, K., & Bone, I. (2002). Improving the assessment of outcomes in stroke: Use of a structured interview to assign grades on the modified rankin scale. Stroke, 33, 22432246.
Wolfe, C.D.A., Taub, N.A., Woodrow, E.J., & Burney, P.G.J. (1991). Assessment of scales of disability and handicap for stroke patients. Stroke, 22, 12421244.
Zigmond, A., & Snaith, R. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67 (6), 361370.

Keywords

Depression and Anxiety Across the First Year After Ischemic Stroke: Findings from a Population-Based New Zealand ARCOS-IV Study

  • Suzanne Barker-Collo (a1), Rita Krishnamurthi (a2), Emma Witt (a3), Alice Theadom (a2), Nicola Starkey (a4), P. Alan Barber (a5), Derrick Bennett (a6), Elaine Rush (a7), Bruce Arroll (a8) and Valery Feigin (a2)...

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