Key result
Fatigue (OR 2.331), sleep problems (OR 2.334), and abnormal movements (OR 2.380) were independent risk factors for comorbid depression and anxiety at 3-4 months poststroke.
Why the study?
Poststroke depression and anxiety are prevalent and impact functional outcome, but beyond stroke severity, little is known about their clinical determinants.
Cohort (n=2,300)
Odds Ratio: 2.331
May aid post-stroke PSED risk assessment; hypothesis-generating and requires prospective validation before practice change.
INTRODUCTION: Poststroke depression (PSD) and anxiety (PSA) are prevalent and have a strong impact on functional outcome. Beside stroke severity, little is known on their clinical determinants. This study investigated the association between stroke mechanism, neurological poststroke complications and remaining vascular risk factors and the presence of comorbid PSD and PSA, termed poststroke emotional distress (PSED). METHODS: This was a retrospective analysis of a prospectively compiled medical records database of consecutive patients evaluated during a follow-up visit 3- to 4-month poststroke. HAD scale was used to define PSED category (PSD+PSA vs. NoPSD+NoPSA). Stroke mechanism and poststroke complications were identified clinically or using appropriate scales. Their association with PSED was tested using a multivariate logistic regression model. RESULTS: The sample included 2,300 patients (male: 64.8%); 19% had a PSED and 56.39% were free of any depression or anxiety. The most frequent poststroke complications were fatigue/fatigability (58.4%), sleep problems (26.7%), and pain (20.4%). While no association was observed between PSED and stroke mechanism, higher functional disability (OR:1.572), lower cognitive abilities (OR:0.953), sleep problems (OR:2.334), pain (OR:1.478), fatigue/fatigability (OR:2.331), and abnormal movements (OR:2.380) were all independent risk factors. Persisting tobacco consumption (OR:1.360) was the only vascular significant risk factor. CONCLUSIONS: The frequency of comorbid PSED remains high (1/5 patient) despite improved awareness of these conditions. The association between poststroke complications and the presence of PSED emphasizes the need for standardized neurological and psychological evaluations at follow-up. These results foster the need to improve the management of addictive behaviors to reduce the burden of PSED.
No takes yet. Share an insight, caveat, or question.
Rabat et al. (2021) conducted a cohort in Poststroke emotional distress (PSED) (n=2,300). Fatigue/fatigability vs. Absence of fatigue/fatigability was evaluated on Comorbid poststroke depression and anxiety (PSED) (OR 2.331). Fatigue (OR 2.331), sleep problems (OR 2.334), and abnormal movements (OR 2.380) were independent risk factors for comorbid depression and anxiety at 3-4 months poststroke.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: