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.
Keywords
List of abbreviations:
AUC (area under the curve), BI (Barthel Index), CI (confidence interval), HADS (Hospital Anxiety and Depression Scale), HADS-A (anxiety subscale of Hospital Anxiety and Depression Scale), HADS-D (depression subscale of Hospital Anxiety and Depression Scale), NIHSS (National Institutes of Health Stroke Scale), OR (odds ratio), UCL-P (Utrecht Coping List passive coping scale), UPCC (Utrecht Proactive Coping Competence list)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 08, 2016
Footnotes
Supported by the VSBfund (grant no. 89000004).
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
