title: Early detection of patients at risk for anxiety, depression and apathy after stroke.
abstract: OBJECTIVE
  The aim of this study was to identify clinical factors in the acute stage that can predict anxiety, depression and apathy at 4 months after stroke.
  
  
  METHODS
  One hundred four consecutive stroke patients in a stroke unit were assessed within the first 2 weeks and after 4 months. Assessments included anxiety and depression symptoms on the Hospital Anxiety and Depression Scale (HADS) [HADS Anxiety subscale (HADS-A) > or = 8 and HADS Depression subscale (HADS-D) > or = 8], physical impairment, functional disability, somatic comorbidity upon admission, assessment of apathy (score > or = 34 on the Apathy Evaluation Scale) and a psychiatric Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of anxiety disorder (anxiety) or depression (depression) on follow-up. Logistic regression analysis was used to identify factors associated with anxiety, depression and apathy.
  
  
  RESULTS
  Anxiety and depression at 4 months were significantly associated with HADS-A scores of > or = 8 upon admission [odds ratio (OR)=4.4; 95% confidence interval (95% CI)=1.7-11.9; P=.003 and OR=2.9; 95% CI=1.0-7.9; P=.043, respectively]. Apathy at 4 months was significantly associated with somatic comorbidity upon admission (OR=3.0; 95% CI=1.0-8.3; P=.036) and had a borderline association with HADS-D scores of > or = 8 (OR=8.4; 95% CI=1.0-72.0; P=.051) upon admission.
  
  
  CONCLUSIONS
  Assessment with HADS within the first 2 weeks of stroke can contribute to the detection of patients at risk for clinically significant anxiety, depression and apathy at 4 months after stroke.
authors.affiliation: Faculty of Medicine, Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, 0317 Oslo, Norway. ulrike.sagen@sthf.no
authors.forename: Ulrike
authors.initials: U
authors.lastname: Sagen
authors.forename: Arnstein
authors.initials: A
authors.lastname: Finset
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Moum
authors.forename: Tore
authors.initials: T
authors.lastname: Mørland
authors.forename: Tom Gunnar
authors.initials: TG
authors.lastname: Vik
authors.forename: Tibor
authors.initials: T
authors.lastname: Nagy
authors.forename: Toril
authors.initials: T
authors.lastname: Dammen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000523:psychology*; D011795:Surveys and Questionnaires