Emotional symptoms in acute ischemic stroke

Background: Anxiety and depressive symptoms encountered in acute stroke influence the patients' neurological outcome and the psychosocial burden of family members. These emotional changes may be caused by the patients' brain damage per se or by psychological reactions. The aims of the present study were to assess the prevalence of anxiety and depressive symptoms in the acute stage of ischemic stroke, and to identify the factors associated with such problems. Methods: Anxiety and depressive symptoms were evaluated in 178 patients with acute ischemic stroke using the Hospital Anxiety and Depression Scale (HADS) between day 3 and 7 after admittance to the stroke unit. Factors associated with anxiety and depressive symptoms were identified using logistic regression analyses. Results: 26.4% of the patients suffered from anxiety symptoms, 14.0% from depressive symptoms and 7.9% from both. Anxiety symptoms were associated with single marital state (OR 2.53, 95% Cl 1.18-5.41) and a low Mini Mental State Examination (MMSE) score (< 26 points) (OR 0.53, 95% CI 0.31-0.87) whereas depressive symptoms were related to a low Barthel Activities of Daily Living index (BI) (score < 90 points) (OR 0.37, 95% Cl. 0.15-0.88). Conclusion: The present study indicates that anxiety symptoms are more frequent than depressive symptoms in the acute stage of ischemic stroke. It is important to focus on both anxiety and depressive symptoms throughout the rehabilitation phase in order to ease the patients' personal anguish and improve neurological outcome after stroke. Copyright (c) 2006 John Wiley & Sons, Ltd.