Psychological Complications at 3 Months Following Stroke: Prevalence and Correlates Among Stroke Survivors in Lebanon.

Walaa Khazaal,Hassan Hosseini,Celina Boutros,Linda Abou-Abbas,Najwane Said Sadier,Maram Taliani,Pascale Salameh

doi:10.3389/fpsyg.2021.663267

Abstract

Introduction: Stroke continues to be a common and debilitating medical condition which has a significant effect on public health as the second primary source of mortality and the third major root of disability worldwide. A wide range of complications affecting the survivor's life and interfering with the recovery process usually follows stroke; anxiety and depression are considered one of the major complications post-stroke. This study sought to investigate the short-term psychological consequences of stroke among Lebanese survivors and to identify their correlates.Methods: This study is a prospective observational epidemiological study. 143 stroke patients admitted to hospitals in Mount Lebanon and Beirut between February and May 2018.were included in this study. Assessments of complications were carried out at 3 months post-stroke by completing a 30-min face-to-face interview questionnaire. The survey included the socio-demographic -characteristics of the patients, their lifestyle, health indicators, the severity of stroke, and the post-stroke consequences disturbing their quality of life.Results: Complications were recorded for 117 stroke survivors (mean age, 72.46 years; 60.7% male). The analysis of results 3 months post stroke showed that 29 survivors suffered from neuropathic pain (24.8%), 110 (94%) suffered from fatigue, and 81 (69.2%) from cognitive impairment. High rates of anxiety (51.3%), and depression (76.1%) were recorded as well. Multivariate logistic regression confirmed that there is a significant association between depression and the following variables: anxiety (OR = 4.814, p-value = 0.017), pain (OR = 6.868, p-value = 0.002), and physical activity, which acts as a protective factor against depression (OR = 0.261; p-value = 0.029). However, the results of the multivariate logistic regression analysis for anxiety indicated that immobility-related complications increase the risk of anxiety by 8.457 in sedentary duration longer than 12 h (ORa = 8.457, p-value = 0.01). Furthermore, patients with neuropathic pain (24.8%) are 3.858 times more likely to have anxiety compared to patients without neuropathic pain (ORa = 3.858, p-value = 0.019).Conclusion: Using a patient-centered structure more interventions should take place to evaluate stroke survivors' outcomes, and organize rehabilitation services that deal with stroke consequences, particularly high anxiety and depression levels, which are prevalent and persistent among the Lebanese stroke survivors.

Highlights

Stroke continues to be a common and debilitating medical condition which has a significant effect on public health as the second primary source of mortality and the third major root of disability worldwide
The inclusion criteria of our study considered Lebanese patients of either sex, aged over 18 years with a clinical diagnosis of first ischemic or hemorrhagic stroke confirmed by a brain CT scan or MRI and that is well-identified by the following codes based on the “International Classification of Diseases” 10 (ICD-10) (I63-I61) (“ICD-10 Version: 2016,” 2016), and classified into cerebrovascular accident, stroke, ischemic stroke, hemorrhagic stroke, intracerebral hemorrhage or embolic/thrombotic stroke
The mean age was 72.46 (SD = 12.44) ranging from 33 to 95 and 60.7% of our sample were aged more than 70 years old, which confirm that stroke mainly occur in the elders

Summary

Introduction

Stroke continues to be a common and debilitating medical condition which has a significant effect on public health as the second primary source of mortality and the third major root of disability worldwide. Hemiparesis and hemiplegia are frequent and widely recognized impairments of stroke where they affect over 65% of stroke survivors (Bindawas et al, 2017) Following this cerebrovascular accident, the ability to perform daily life activities is greatly affected by physical disability, essentially upper extremities involvement, and cognitive impairment fluctuating between minor vascular cognitive impairment (VCI) and vascular dementia (VaD) (Arauz et al, 2014; Kwakkel et al, 2015). The ability to perform daily life activities is greatly affected by physical disability, essentially upper extremities involvement, and cognitive impairment fluctuating between minor vascular cognitive impairment (VCI) and vascular dementia (VaD) (Arauz et al, 2014; Kwakkel et al, 2015) Another consequence is participation restrictions represented by loss or decline in social engagement (Scott et al, 2012).

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