title: Depression but not anxiety predicts recurrent cerebrovascular events.
abstract: OBJECTIVE
  Depression and anxiety after stroke occur frequently and have been suggested to have negative influence on functional outcomes. However, the effect of emotional symptoms on stroke recurrence is uncertain. The aim of this study was to define the effect of emotional symptoms on recurrent cerebrovascular events in patients with ischemic stroke.
  
  
  METHODS
  This was a hospital-based cohort study including patients with ischemic stroke who participated in a Community Stroke Care Program that provided secondary stroke prevention strategies during 6 months transition period after discharge. We examined the association between depression and anxiety and the risk of recurrent cerebrovascular events using logistic regression model. Depression and anxiety were defined as a score of 7 or more in Hospital Anxiety and Depression Scale at 2 weeks after discharge. Recurrent cerebrovascular events comprised any recurrent stroke and transient ischemic attack (TIA) occurring during 6 months after discharge.
  
  
  RESULTS
  Among 182 patients, 29 (15.9%) were depressed and 41 (22.5%) had anxiety symptoms. During the follow-up period, 9 patients experienced recurrent cerebrovascular events (5 of stroke and 4 of TIA). Depression was associated with recurrent cerebrovascular events at 6 months after adjustment for age, sex, and stroke severity (OR 5.22, 95% CI 1.08-25.12; P = 0.04), whereas anxiety was not (OR 0.98, 95% CI 0.2-4.92; P = 0.982).
  
  
  CONCLUSIONS
  Depression occurring early after stroke was associated with the increased risk of recurrent cerebrovascular events in ischemic stroke survivors. Care plan to detect and manage depression should be implemented to prevent recurrent stroke.
authors.affiliation: Department of Neurology, Korea University College of Medicine, Seoul, Korea.|The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia.|Department of Neurology, Royal North Shore Hospital, St Leonards and University of Sydney, Sydney, NSW, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Yu
authors.affiliation: The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Arima
authors.affiliation: Department of Neurology, Royal North Shore Hospital, St Leonards and University of Sydney, Sydney, NSW, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Bertmar
authors.affiliation: The George Institute for Global Health, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia.
authors.forename: Y
authors.initials: Y
authors.lastname: Hirakawa
authors.affiliation: Department of Neurology, Royal North Shore Hospital, St Leonards and University of Sydney, Sydney, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Priglinger
authors.affiliation: Department of Neurology, Royal North Shore Hospital, St Leonards and University of Sydney, Sydney, NSW, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Evans
authors.affiliation: Department of Neurology, Royal North Shore Hospital, St Leonards and University of Sydney, Sydney, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Krause
mesh_terms: D000368:Aged; D001007:Anxiety / Q000150:complications; D015331:Cohort Studies; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000150:complications / Q000523:psychology*; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D013997:Time Factors
keywords: anxiety; cerebrovascular event; depression; recurrent stroke