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|Title:||Factors influencing self-reported anxiety or depression following stroke or TIA using linked registry and hospital data.|
|Authors:||Thayabaranathan, Tharshanah;Andrew, Nadine E;Kilkenny, Monique F;Stolwyk, Rene;Thrift, Amanda G;Grimley, Rohan;Johnston, Trisha;Sundararajan, Vijaya;Lannin, Natasha A;Cadilhac, Dominique A|
|Affiliation:||Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia|
Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC, Australia
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
Sunshine Coast Clinical School, The University of Queensland, Birtinya, QLD, Australia
Statistical Services Branch, Queensland Department of Health, Brisbane, QLD, Australia
St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
School of Allied Health, La Trobe University, Bundoora, VIC, Australia..
Stroke Division, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
|Citation:||Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 2018; online first: 4 August|
|Abstract:||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. 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. 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. Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.|
Quality of life
|Appears in Collections:||Journal articles|
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