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04-08-2018 | Uitgave 12/2018

Quality of Life Research 12/2018

Factors influencing self-reported anxiety or depression following stroke or TIA using linked registry and hospital data

Tijdschrift:
Quality of Life Research > Uitgave 12/2018
Auteurs:
Tharshanah Thayabaranathan, Nadine E. Andrew, Monique F. Kilkenny, Rene Stolwyk, Amanda G. Thrift, Rohan Grimley, Trisha Johnston, Vijaya Sundararajan, Natasha A. Lannin, Dominique A. Cadilhac
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11136-018-1960-y) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Approximately 30–50% of survivors experience problems with anxiety or depression post-stroke. It is important to understand the factors associated with post-stroke anxiety or depression to identify effective interventions.

Methods

Patient-level data from the Australian Stroke Clinical Registry (years 2009–2013), from participating hospitals in Queensland (n = 23), were linked with Queensland Hospital Emergency and Admission datasets. Self-reported anxiety or depression was assessed using the EQ-5D-3L, obtained at 90–180 days post-stroke. Multivariable multilevel logistic regression, with manual stepwise elimination of variables, was used to investigate the association between self-reported anxiety or depression, patient factors and acute stroke processes of care. Comorbidities, including prior mental health problems (e.g. anxiety, depression and dementia) coded in previous hospital admissions or emergency presentations using ICD-10 diagnosis codes, were identified from 5 years prior to stroke event.

Results

2853 patients were included (median age 74; 45% female; 72% stroke; 24% transient ischaemic attack). Nearly half (47%) reported some level of anxiety or depression post-stroke. The factors most strongly associated with anxiety or depression were a prior diagnosis of anxiety or depression [Adjusted Odds Ratio (aOR) 2.37, 95% confidence interval (95% CI) 1.66–3.39; p < 0.001], dementia (aOR 1.91, 95% CI 1.24–2.93; p = 0.003), being at home with support (aOR 1.41, 95% CI 1.12–1.69; p = < 0.001), and low socioeconomic advantage compared to high (aOR 1.59, 95% CI 1.21–2.10; p = 0.001). Acute stroke processes of care were not independently associated with anxiety or depression.

Conclusions

Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.

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