Depression and anxiety symptoms post-stroke/TIA: prevalence and associations in cross-sectional data from a regional stroke registry

Niall M Broomfield, Terence J Quinn, Azmil H Abdul-Rahim, Matthew R Walters, Jonathan J Evans, Niall M Broomfield, Terence J Quinn, Azmil H Abdul-Rahim, Matthew R Walters, Jonathan J Evans

Abstract

Background: Mood disorders are commonly seen in those with cerebrovascular disease. Literature to-date has tended to focus on depression and on patients with stroke, with relatively little known about post-stroke anxiety or mood disorder in those with transient ischaemic attack (TIA). We aimed to describe prevalence of depression and anxiety symptoms in stroke and TIA cohorts and to explore association with clinical and socio-demographic factors.

Methods: We used a city wide primary care stroke registry (Glasgow Local Enhanced Service for Stroke - LES). All community dwelling stroke-survivors were included. We described cross-sectional prevalence of depression and anxiety symptoms using the Hospital Anxiety and Depression Scale (HADS). Data on clinical and demographic details was collected and univariable and multivariable analyses performed to describe associations with HADS scores. We examined those with a diagnosis of 'stroke' and 'TIA' as separate cohorts.

Results: From 13,283 potentially eligible stroke patients in the registry, we had full HADS data on 4,079. Of the 3,584 potentially eligible TIA patients, we had full HADS data on 1,247 patients. Across the stroke cohort, 1181 (29%) had HADS anxiety scores suggestive of probable or possible anxiety; 993 (24%) for depression. For TIA patients, 361 (29%) had anxiety and 254 (21%) had depression. Independent predictors of both depression and anxiety symptoms were female sex, younger age and higher socioeconomic deprivation score (all p < 0.001).

Conclusion: Using HADS, we found a high prevalence of anxiety and depression symptoms in a community-based cohort of patients with cerebrovascular disease.

Figures

Figure 1
Figure 1
Flow chart for selection of; a) stroke cohort and, b) minor stroke/TIA cohort; from the local enhanced service stroke database.
Figure 2
Figure 2
Forrest plot shows variable’s association with caseness for anxiety in TIA cohort (unadjusted univariable analysis). IHD: ischaemic heart diease; COPD: Chronic Obstructive Pulmonary Disease. OR and corresponding 95% CI express the odds of caseness for anxiety in univariable analysis.
Figure 3
Figure 3
Forrest plot shows variable’s association with caseness for depression in TIA cohort (unadjusted univariable analysis). IHD: ischaemic heart diease; COPD: Chronic Obstructive Pulmonary Disease. OR and corresponding 95% CI express the odds of caseness for depression in univariable analysis.

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