An evaluation of use of the HADS scale to screen for post-stroke depression in practice

Abstract

Widely differing methods of diagnosis and definition mean that the incidence of post-stroke depression has been reported at between 30% and 60%. Despite this apparent disparity, these statistics reveal that depression after stroke is common and that the symptoms may cause a great deal of distress to both the patient and his/her family. Post-stroke depression may also limit rehabilitation and have a profound impact on outcome and quality of life. The National Service Framework for Older People and the Royal College of Physicians' National Clinical Guidelines for Stroke stipulate that stroke patients should be screened for depression within 1 month of stroke, and that the patient's mood should be kept under review. A number of difficulties are encountered in screening patients for depression after stroke and a number of different screening tools are available. The aim of the pilot described here was to evaluate the use of one of these tools, the Hospital Anxiety and Depression Scale (HADS), to screen patients for post-stroke depression in practice. The HADS was found to be an effective screening method for those patients who can self-assess or require minimal assistance. A number of recommendations are made for monitoring depression in stroke patients in line with national guidelines.