Risk Factors for Symptoms of Depression and Anxiety One Year Poststroke: A Longitudinal Study
Abstract Objective To estimate the relative contribution of psychological factors next to sociodemographic and premorbid/stroke-related factors to the risk of developing symptoms of depression and anxiety after stroke. Design Multicenter, longitudinal cohort study. Setting Patients after stroke from...
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Veröffentlicht in: | Archives of physical medicine and rehabilitation 2016-06, Vol.97 (6), p.919-928 |
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Sprache: | eng |
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Zusammenfassung: | Abstract Objective To estimate the relative contribution of psychological factors next to sociodemographic and premorbid/stroke-related factors to the risk of developing symptoms of depression and anxiety after stroke. Design Multicenter, longitudinal cohort study. Setting Patients after stroke from 6 general hospitals. Participants Patients (N=331) were included at stroke onset and followed up 2 and 12 months after stroke. Interventions Not applicable. Main Outcome Measures Sociodemographic and premorbid/stroke-related information was recorded during hospital admission, whereas psychological characteristics were determined with postal questionnaires 2 months poststroke. Symptoms of depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS) 2 and 12 months poststroke. Multivariable logistic analysis was performed to analyze the influence of sociodemographic, premorbid/stroke-related, and psychological characteristics on depressive symptoms (depression subscale of HADS >7) and symptoms of anxiety (anxiety subscale of HADS >7) 1 year after stroke. Results Early depression, stroke severity, posterior cerebral artery stroke, and neuroticism independently explained the variance of depressive symptoms 1 year poststroke (discriminative power, 83%; adjusted R2 value, 36%). Neuroticism and early anxiety independently explained the variance of symptoms of anxiety 1 year poststroke (discriminative power, 88%; adjusted R2 value, 44%). Based on these predictive models, nomograms were constructed to visually reflect the individual contribution of each risk factor to the development of long-term mood disorders after stroke. Conclusions Psychological characteristics are important risk factors for poststroke symptoms of depression and anxiety. |
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ISSN: | 0003-9993 1532-821X |
DOI: | 10.1016/j.apmr.2016.01.019 |