In-Hospital Symptoms of Depression and Anxiety are Strong Risk Factors for Post-Stroke Depression 90 Days After Ischemic Stroke

Author:

Elias Stefany1ORCID,Benevides Maria Luiza2ORCID,Pereira Martins André Luiz1,Martins Gladys Lentz3,Sperb Wanderley Marcos Ana Beatriz4,Nunes Jean Costa56

Affiliation:

1. University of Southern Santa Catarina, Santa Catarina, Brazil

2. Child Neurology Department of University of Campinas (UNICAMP), São Paulo, Brazil

3. Department of Neurology, Hospital Governador Celso Ramos (HGCR), Florianópolis, Brazil

4. Department of Medical Sciences, Hospital Polydoro Ernani de São Thiago, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil

5. Department of Pathology, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil

6. Neurodiagnostic Brasil – Diagnósticos em Neuropatologia, Florianópolis, Brazil

Abstract

Background and Purpose Acute ischemic stroke (AIS) and depression are the major causes of disability and decreased quality of life worldwide. Psychiatric disorders are common after stroke, especially post-stroke depression (PSD), which affects one-third of survivors. Although frequent, little is known about the real complexity of the pathophysiology and the factors associated with PSD. Methods This research aimed to provide data about risk factors and predictors of PSD 90 days after AIS. A cohort study was conducted in a tertiary stroke center located in southern Brazil. We interviewed 148 patients with AIS who were consecutively hospitalized between January 2020 and January 2021. The Hospital Anxiety and Depression Scale (HADS) was applied during hospitalization and at follow-up 90 days after AIS. Furthermore, sociodemographic, clinical, and radiological variables were investigated. Predictive factors were assessed using univariate and multivariate linear regression. The impact of the COVID-19 pandemic on the data was also evaluated. Results The frequency of PSD 90 days after AIS was 33.9%. In-hospital symptoms of depression and anxiety each represented a 2-fold risk for PSD at follow-up. Furthermore, the HADS – anxiety score 90 days after AIS was strongly associated with the HADS – depression value 90 days after stroke (R: .71; B: .56; P < .01). Conclusions The present study highlighted a noteworthy frequency of PSD 90 days after AIS. Psychiatric variables during hospitalization and in the follow-up appeared to be the leading associated factors with PSD. These data might support the determination of which patients require more psychiatric management.

Publisher

SAGE Publications

Subject

Neurology (clinical)

Reference28 articles.

1. Global Burden of Disease (GBD) Brazil. Global burden of disease data; 2017. [Internet]. http://svs.aids.gov.br/dantps/centrais-de-conteudos/paineis-de-monitoramento/mortalidade/gbd-brasil/principais-causas/. Accessed July 2, 2021.

2. World Health Organization - WHO. Global health observatory data: World health statistics, 2019. [Internet]. https://www.who.int/gho/publications/world_health_statistics/2019/en/. Accessed July 2, 2021.

3. Management of Acute Ischemic Stroke

4. Post stroke depression: The sequelae of cerebral stroke

5. Predictors of depressive symptoms in patients with stroke – a three-month follow-up

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