Anxiety and depression after stroke: a 5 year follow-up.
OBJECTIVE
The aim was to document the prevalence and predictors of anxiety and depression 5 years after stroke, across four European centres.


METHODS
A cohort of 220 stroke patients was assessed at 2, 4 and 6 months and 5 years after stroke. Patients were assessed on the Hospital Anxiety and Depression Scale and measures of motor function and independence in activities of daily living.


RESULTS
At 5 years, the prevalence of anxiety was 29% and depression 33%, with no significant differences between centres. The severity of anxiety and depression increased significantly between 6 months and 5 years. Higher anxiety at 6 months and centre were significantly associated with anxiety at 5 years, but not measures of functional recovery. Higher depression scores at 6 months, older age and centre, but not measures of functional recovery, were associated with depression at 5 years.


CONCLUSIONS
Anxiety and depression were more frequent at 5 years after stroke than at 6 months. There were significant differences between four European centres in the severity of anxiety and depression. Although the main determinant of anxiety or depression scores at 5 years was the level of anxiety or depression at 6 months, this accounted for little of the variance. Centre was also a significant predictor of mood at 5 years. There needs to be greater recognition of the development of mood disorders late after stroke and evaluation of variation in management policies across centres.
Institute of Work, Health and Organisations, University of Nottingham, Nottingham, UK. nadina.lincoln@nottingham.ac.uk
N B
NB
Lincoln
N
N
Brinkmann
S
S
Cunningham
E
E
Dejaeger
W
W
De Weerdt
W
W
Jenni
A
A
Mahdzir
K
K
Putman
W
W
Schupp
B
B
Schuback
L
L
De Wit
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012720:Severity of Illness Index; D020521:Stroke / Q000523:psychology*; D013997:Time Factors