Literature DB >> 20114132

Early detection of patients at risk for anxiety, depression and apathy after stroke.

Ulrike Sagen1, Arnstein Finset, Torbjørn Moum, Tore Mørland, Tom Gunnar Vik, Tibor Nagy, Toril Dammen.   

Abstract

BACKGROUND AND
PURPOSE: The aim of this study was to identify clinical factors in the acute stage that can predict anxiety, depression and apathy at 4 months after stroke.
METHODS: One hundred four consecutive stroke patients in a stroke unit were assessed within the first 2 weeks and after 4 months. Assessments included anxiety and depression symptoms on the Hospital Anxiety and Depression Scale (HADS) [HADS Anxiety subscale (HADS-A) > or = 8 and HADS Depression subscale (HADS-D) > or = 8], physical impairment, functional disability, somatic comorbidity upon admission, assessment of apathy (score > or = 34 on the Apathy Evaluation Scale) and a psychiatric Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of anxiety disorder (anxiety) or depression (depression) on follow-up. Logistic regression analysis was used to identify factors associated with anxiety, depression and apathy.
RESULTS: Anxiety and depression at 4 months were significantly associated with HADS-A scores of > or = 8 upon admission [odds ratio (OR)=4.4; 95% confidence interval (95% CI)=1.7-11.9; P=.003 and OR=2.9; 95% CI=1.0-7.9; P=.043, respectively]. Apathy at 4 months was significantly associated with somatic comorbidity upon admission (OR=3.0; 95% CI=1.0-8.3; P=.036) and had a borderline association with HADS-D scores of > or = 8 (OR=8.4; 95% CI=1.0-72.0; P=.051) upon admission.
CONCLUSION: Assessment with HADS within the first 2 weeks of stroke can contribute to the detection of patients at risk for clinically significant anxiety, depression and apathy at 4 months after stroke. Copyright 2010 Elsevier Inc. All rights reserved.

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Year:  2009        PMID: 20114132     DOI: 10.1016/j.genhosppsych.2009.10.001

Source DB:  PubMed          Journal:  Gen Hosp Psychiatry        ISSN: 0163-8343            Impact factor:   3.238


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