Symptomatology of Depression and Anxiety After Ischemic Stroke in Different Evolution Periods

Abstract

Background: Several studies suggest a high prevalence of symptoms of depression and anxiety after stroke. However, the prevalence and severity of this symptomatology may vary according to the period after a stroke in which the patient is assessed. Goals: This study aims to compare the depressive and anxious symptoms of a population of patients who suffered from ischemic stroke and who are in different evolution periods after stroke.Methods: This is an observational cross-sectional study. Participants were all individuals with ischemic stroke, without previous history of psychiatric disease nor pathologies involving Central Nervous System compromise or cognitive deficits, recruited from hospitals or from support units of the Rede Regional de Cuidados Continuados Integrados of the Região Autónoma da Madeira, Portugal. Participants were divided into four groups according to the post- stroke evolution period: short duration (0 to 3 months after the stroke), medium duration (4 to 12 months), chronic period I (13 to 24 months) and chronic period II (more than 24 months after the stroke). Data were collected by a psychologist, with the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory, Form Y (STAI-Y), in individual self-report sessions. Results: The study included 42 patients with ischemic stroke, 52.4% males, aged 55-88 years. The different post-stroke evolution period groups do not differ in age, sex, level of education, hemispheric location of the lesion or cognitive functioning. The results showed that the prevalence of depression is higher in the chronic group II; regarding the prevalence of anxiety, no significant differences were found between the four groups. As for the severity of symptoms of depression, it is also significantly higher in the chronic group II. With regard to anxiety, trait and state anxiety levels are higher in the medium duration group compared to participants in the short duration period. It was also observed higher levels of state anxiety in the medium duration group compared to the chronic group I. Discussion: These results suggest the need to identify early emotional changes inherent to this population. These changes can have a major impact on the assessment, follow-up and neuropsychological rehabilitation of patients, so that their early identification will allow a more adequate intervention.Keywords: Ischemic stroke; Depression; Anxiety; Emotional changes.