P91: Symptoms of Anxiety and Depression after stroke – a follow up study in outpatients followed in a rehabilitation recovery unit

Abstract

Background:

Depression and anxiety persist in a large number of patients after stroke. Anxiety affects around one third of patients during the first year. Nowadays, this phenomenon receives significantly less attention compared to other psychological problems, and poor psychological services after the onset of the disease were reported in previous studies. Some patients have access to specialized rehabilitation units (“Integrated Continuing Care Unit, UCCI”) that can ameliorate anxiety and significantly improve health-related quality-of-life (QoL), avoiding depression and improve patients' functional disability.

Objective:

To analyze the associations between anxiety/depression symptoms and QoL in patients with chronic stroke, during and after discharge from UCCI.

Methods:

An observational, longitudinal and descriptive study was carried out with patients with a clinical history of stroke discharged from hospitals in Portuguese central area, aged ≥65 years, without dementia diagnosis. Patients were observed at admission at the rehabilitation unit, discharge, and 6 and 12 months after discharge, and data were collected through a protocol composed of several self- completion instruments, namely the Hospital Anxiety and Depression Scale (HADS) and Stroke Specific Quality-of-Life Scale (SS-QoL). Data on clinical and demographic variables were collected and analyses performed to describe associations with HADS scores. Data were collected from August/2020 to July/2022 and analyzed using SPSS®,V.26.0.

Results:

A cohort of 154 stroke patients was assessed (M/F ratio=1.8, age 75±9 years). Anxiety scores were 6.8(4.8) (6 months) and 5.8(4.1) (12 months). Depression scores were 8.7(5.3) (6 months) and 8.1(4.7); (12 months). Anxiety total score at 6 months was significantly related (p<0.05) with 3 domains of SS- QoL (Personality, Social Role and Work/Productivity). However, no differences were found at 12 months. Depression was significantly related with all domains of SS-QoL except Vision (p<0.05).

Conclusion:

HADS score for anxiety were normal (0-7) at 6 and 12 months; however, depression remain in the Borderline abnormal classification (8-10), 6 and 12 months after stroke, which appear to have a negative impact in almost all SS-QoL domains of patients with chronic stroke. The current study highlights the need to prevent depression symptoms after stroke as this can negatively affect the functional recovery of the entire ongoing rehabilitation process.