Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T22:12:36.490Z Has data issue: false hasContentIssue false

Post-stroke depression and post-stroke anxiety: prevalence and predictors

Published online by Cambridge University Press:  16 July 2015

Henning Schöttke
Affiliation:
Institute of Psychology, Osnabrück University, Knollstr. 15, 49069 Osnabrück, Germany
Claire-Marie Giabbiconi*
Affiliation:
Institute of Psychology, Osnabrück University, Knollstr. 15, 49069 Osnabrück, Germany
*
Correspondence should be addressed to: Dr. Claire-Marie Giabbiconi, Institute of Psychology, Osnabrück University, Knollstr. 15, D-49069 Osnabrück, Germany. Phone: +49-(0)541 969-6290; Fax: +49-(0)541 969-4028. E-mail: cgiabbic@uos.de.

Abstract

Background:

Epidemiological research on post-stroke affective disorders has been mainly focusing on post-stroke depression (PSD). In contrast, research on post-stroke anxiety (PSA) is in its early stages. The present study proposes a broad picture on post-stroke affective disorders, including PSD and PSA in German stroke in-patients during rehabilitation. In addition, we investigated whether lifetime affective disorders predict the emergence of PSD and PSA.

Methods:

289 stroke patients were assessed in the early weeks following stroke for a range of mood and anxiety disorders by means of the Structured Clinical Interview relying on the Diagnostic and Statistical Manual of Mental Disorders IV. This assessment was conducted for two periods: for post-stroke and retroactively for the period preceding stroke (lifetime). The covariation between PSD and PSA was investigated using Spearman-ρ correlation. Predictors of PSD and PSA prevalence based on the respective lifetime prevalence were investigated using logistic regression analyses.

Results:

PSD prevalence was 31.1%, PSA prevalence was 20.4%. We also found significant correlations between depression and anxiety at post-stroke and for the lifetime period. Interestingly, lifetime depression could not predict the emergence of PSD. In contrast, lifetime anxiety was a good predictor of PSA.

Conclusions:

We were able to highlight the complexity of post-stroke affective disorders by strengthening the comorbidity of depression and anxiety. In addition, we contrasted the predictability of PSA based on its lifetime history compared to PSD which was not predictable based on lifetime depression.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ayerbe, L., Ayis, S., Crichton, S., Wolfe, C. D. and Rudd, A. G. (2013a). The natural history of depression up to 15 years after stroke: the South London Stroke Register. Stroke, 44, 11051110.CrossRefGoogle ScholarPubMed
Ayerbe, L., Ayis, S. A., Crichton, S., Wolfe, C. D. and Rudd, A. G. (2014). Natural history, predictors and associated outcomes of anxiety up to 10 years after stroke: the South London Stroke Register. Age Ageing, 43, 542547.CrossRefGoogle ScholarPubMed
Ayerbe, L., Ayis, S., Rudd, A. G., Heuschmann, P. U. and Wolfe, C. D. (2011). Natural history, predictors, and associations of depression 5 years after stroke: the South London Stroke Register. Stroke, 42, 19071911.CrossRefGoogle ScholarPubMed
Ayerbe, L., Ayis, S., Wolfe, C. D. and Rudd, A. G. (2013b). Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis. British Journal of Psychiatry, 202, 1421.CrossRefGoogle ScholarPubMed
Barker-Collo, S. L. (2007). Depression and anxiety 3 months post stroke: prevalence and correlates. Archives of Clinical of Neuropsychology, 22, 519531.CrossRefGoogle ScholarPubMed
Brainin, M. (1989). Risiko und Prognose des Schlaganfalls. Der Beitrag von Datenbanken. Berlin, Heidelberg, New York: Springer Verlag.CrossRefGoogle Scholar
Burvill, P. W., Johnson, G. A., Jamrozik, K. D., Anderson, C. S., Stewart-Wynne, E. G. and Chakera, T. M. (1995). Anxiety disorders after stroke: results from the Perth Community Stroke Study. British Journal of Psychiatry, 166, 328332.CrossRefGoogle ScholarPubMed
Busch, M. A., Schienkiewitz, E., Nowossadeck, E. and Gößwald, A. (2013). Prevalence of stroke in adults aged 40–79 years in Germany. Results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt, 56, 656660.CrossRefGoogle ScholarPubMed
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurrence of mood and anxiety disorders among older adults: the national comorbidity survey replication. Archives of General Psychiatry, 67, 489496.CrossRefGoogle ScholarPubMed
Caeiro, L., Ferro, J. M., Santos, C. O. and Figueira, M. L. (2006). Depression in acute stroke. Journal of Psychiatry & Neuroscience, 31, 377383.Google ScholarPubMed
Campbell Burton, C. A., Murray, J., Holmes, J., Astin, F., Greenwood, D. and Knapp, P. (2013). Frequency of anxiety after stroke: a systematic review and meta-analysis of observational studies. International Journal of Stroke, 8, 545559.CrossRefGoogle ScholarPubMed
Christensen, A.-L. and Uzzell, B. P. (2000). International Handbook of Neuropsychological Rehabilitation. New York: Springer Science and Business Media.CrossRefGoogle Scholar
Elfron, B. and Tibshirani, R. (1986). Bootstrap methods for standard errors, confidence intervals, and other measures of statistical accuracy. Statistical Science, 1, 5475.Google Scholar
Fiedorowicz, J. G., He, J. and Merikangas, K. R. (2011). The association between mood and anxiety disorders with vascular diseases and risk factors in a nationally representative sample. Journal of Psychosomatic Research, 70, 145154.CrossRefGoogle Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). Washinghton, DC: American Psychiatric Press, Inc.Google Scholar
Hellmann-Regen, J. et al. (2013). Depressive syndromes in neurological disorders. European Archives of Psychiatry and Clinical Neuroscience, 263, 123136.CrossRefGoogle ScholarPubMed
House, A., Dennis, M., Mogridge, L., Warlow, C., Hawton, K. and Jones, L. (1991). Mood disorders in the year after first stroke. British Journal of Psychiatry, 158, 8392.CrossRefGoogle ScholarPubMed
Kessler, R. C., DuPont, R. L., Berglund, P. and Wittchen, H. U. (1999). Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. American Journal of Psychiatry, 156, 19151923.CrossRefGoogle ScholarPubMed
Lambiase, M. J., Kubzansky, L. D. and Thurston, R. C. (2014). Prospective study of anxiety and incident stroke. Stroke, 45, 438443.CrossRefGoogle ScholarPubMed
Leppavuori, A., Pohjasvaara, T., Vataja, R., Kaste, M. and Erkinjuntti, T. (2003). Generalized anxiety disorders three to four months after ischemic stroke. Cerebrovascular Disease, 16, 257264.CrossRefGoogle ScholarPubMed
Lincoln, N. B. et al. (2013). Anxiety and depression after stroke: a 5 year follow-up. Disability and Rehabilitation, 35, 140145.CrossRefGoogle ScholarPubMed
Meng, X.-L., Rosenthal, R. and Rubin, D. B. (1992). Comparing correlated correlation coefficients. Psychological Bulletin, 111, 172175.CrossRefGoogle Scholar
Robinson, R. G. (2003). Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Society of Biological Psychiatry, 54, 376387.CrossRefGoogle ScholarPubMed
Schönle, P. W. (1996). Frühe Phasen der neurologischen rehabilitation: differentielle Schweregradbeurteilung bei Patienten in der Phase B (Frührehabilitation) und in der Phase C (Frühmobilisation/Postprimäre Rehabilitation) mit Hilfe des Frühreha-Barthel-Index (FRB). Neurologische Rehabilitation, 1, 2125.Google Scholar
Schramke, C. J., Stowe, R. M., Ratcliff, G., Goldstein, G. and Condray, R. (1998). Poststroke depression and anxiety: different assessment methods result in variations in incidence and severity estimates. Journal of Clinical and Experimental Neuropsychology, 20, 723737.Google ScholarPubMed
Tang, W. K., Lau, C. G., Mok, V., Ungvari, G. S. and Wong, K. S. (2013). Impact of anxiety on health-related quality of life after stroke: a cross-sectional study. Archives of Physical Medicine and Rehabilitation, 94, 25352541.CrossRefGoogle ScholarPubMed
Wittchen, H. U. et al. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21, 655679.CrossRefGoogle ScholarPubMed