Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T03:48:40.097Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  29 June 2017

Suzanne Barker-Collo ,
Rita Krishnamurthi ,
Emma Witt ,
Alice Theadom ,
Nicola Starkey ,
P. Alan Barber ,
Derrick Bennett ,
Elaine Rush ,
Bruce Arroll  and
Valery Feigin
Suzanne Barker-Collo*
Affiliation:
School of Psychology, The University of Auckland, Private Bag 92019, Auckland, New Zealand
Rita Krishnamurthi
Affiliation:
National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand
Emma Witt
Affiliation:
Department of Biostatistics, Faculty of Health Sciences, AUT University, Private Bag 92006, Auckland, New Zealand
Alice Theadom
Affiliation:
National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand
Nicola Starkey
Affiliation:
School of Psychology, Waikato University, Hamilton, New Zealand
P. Alan Barber
Affiliation:
Department of Neurology, Auckland City Hospital, Centre for Brain Research, University of Auckland; Private Bag 92019, Auckland, New Zealand
Derrick Bennett
Affiliation:
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
Elaine Rush
Affiliation:
Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand
Bruce Arroll
Affiliation:
FRNZCGP, Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland, New Zealand
Valery Feigin
Affiliation:
National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, AUT University, Private Bag 92006, Auckland, New Zealand
*
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
Get access

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.

Keywords

Moodoutcomeprognosticstrokeepidemiological
Type
Articles
Information
Brain Impairment , Volume 18 , Issue 3 , December 2017 , pp. 265 - 276
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2017 

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

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), 581–585.CrossRefGoogle ScholarPubMed
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, 113–130.Google ScholarPubMed
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, 55–63.CrossRefGoogle Scholar
Åstrom, M., Adolfsson, R., & Asplund, K. (1993). Major depression in stroke patients: A 3-year longitudinal study. Stroke, 24, 976–982.CrossRefGoogle ScholarPubMed
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, 14–21.CrossRefGoogle ScholarPubMed
Barker-Collo, S.L. (2007). Depression and anxiety 3 months post stroke: Prevalence and correlates. Archives of Clinical Neuropsychology, 22, 519–531.CrossRefGoogle ScholarPubMed
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), 69–77.CrossRefGoogle ScholarPubMed
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, 477–486.CrossRefGoogle ScholarPubMed
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, 198–206.CrossRefGoogle ScholarPubMed
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, 545–559.CrossRefGoogle Scholar
Carod-Artal, F. (2006). Depresion postictus. Epidemiologia, criterios diagnosticos y factores de riesgo. Reviews in Neurology, 42, 169–175.Google Scholar
Dafer, R., Rao, S., Shareef, A., & Sharma, A. (2008). Poststroke depression. Topics in Stroke Rehabilitation, 15, 13–21.CrossRefGoogle ScholarPubMed
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, 147–158.CrossRefGoogle ScholarPubMed
Gilbody, S., Sheldon, T., & House, A. (2008). Screening and case-finding instruments for depression: A meta-analysis. Canadian Medical Association Journal, 178 (8), 997–1003.CrossRefGoogle ScholarPubMed
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, 14–17.Google ScholarPubMed
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, 1017–1025.CrossRefGoogle ScholarPubMed
Hackett, M., Anderson, C., House, A., & Xia, J. (2008). Interventions for treating depression after stroke. Cochrane Database Systematic Reviews, 8 (4), CD003437.Google Scholar
Hackett, M.L., & Anderson, C.S. (2014). Predictors of depression after stroke. A systematic review of observational studies. Stroke, 36, 2296–2301.CrossRefGoogle Scholar
Health, M.o. (2013). New Zealand health survey: Annual update of key findings 2012/13. Wellington, New Zealand: Ministry of health.Google Scholar
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, 188–190.CrossRefGoogle ScholarPubMed
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), 1627–1636.CrossRefGoogle ScholarPubMed
Johnson, J., Minarik, P., & Nystrom, K. (2006). Poststroke depression incidence and risk factors: An integrative literature review. Journal of Neuroscience Nursing, 38, 316–327.CrossRefGoogle ScholarPubMed
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), 33–41.CrossRefGoogle ScholarPubMed
Kim, J.S. (2016). Post-stroke mood and emotional disturbances: Pharmacological therapy based on mechanisms. Journal of Stroke, 18 (3), 244–255.CrossRefGoogle Scholar
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), 140–147.CrossRefGoogle ScholarPubMed
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, 1026–1036.CrossRefGoogle ScholarPubMed
Lindén, T., Blomstrand, C., & Skoog, I. (2007). Depressive disorders after 20 months in elderly stroke patients: A case-control study. Stroke, 38 (6), 1860–1863.CrossRefGoogle ScholarPubMed
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, 2989–2994.CrossRefGoogle ScholarPubMed
Robinson, R., & Jorge, R. (2016). Post-stroke depression: A review. American Journal of Psychiatry, 173 (3), 221–231.CrossRefGoogle ScholarPubMed
Sachdev, P.S. (1989). Psychiatric illness in New Zealand Maori. Australia and New Zealand Journal of Psychiatry, 23 (4), 529–541.CrossRefGoogle ScholarPubMed
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, 930–935.CrossRefGoogle ScholarPubMed
Simon, G., & VonKorff, M. (1995). Recognition, management, and outcomes of depression in primary care. Archives of Family Medicine, 4 (2), 99–105.CrossRefGoogle ScholarPubMed
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), 429–432.CrossRefGoogle ScholarPubMed
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), 156–162.CrossRefGoogle ScholarPubMed
Verdelho, A., Henon, H., & Lebert, F. (2004). Depressive symptoms after stroke and relationship with dementia: A three-year follow-up study. Neurology, 62, 905–911.CrossRefGoogle ScholarPubMed
Whyte, E.M., & Mulsant, B.H. (2002). Post stroke depression: Epidemiology, pathophysiology, and biological treatment. Biological Psychiatry, 52 (3), 253–264.CrossRefGoogle ScholarPubMed
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, 2243–2246.CrossRefGoogle ScholarPubMed
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, 1242–1244.CrossRefGoogle ScholarPubMed
Zigmond, A., & Snaith, R. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67 (6), 361–370.CrossRefGoogle ScholarPubMed