A follow-up study of psychological problems after stroke

Abstract

Purpose: Psychological problems are common complications following stroke and have an impact on all aspects of recovery. This article investigates levels of psychological distress in patients during hospital admission and after discharge into the community. Early detection and review of poststroke psychological problems may optimize recovery from stroke as recommended in the national stroke guideline. Currently, there are very few follow-up investigations on poststroke mood disorders available that could inform clinical practice.

Method: Psychological symptoms were defined as poststroke anxiety and depression and were measured using the Hospital Anxiety and Depression Scale (HADS). Revised cutoff scores for this clinical group were applied. Seventy-seven stroke patients were assessed in the hospital. Forty-two patients from this sample were reassessed after their discharge into the community.

Results: Patients in the hospital sample presented with mean anxiety and depression scores above the recommended cutoff for stroke. Far more than 50% of male and female patients presented with heightened psychological distress. Psychological symptoms were slightly less intense and less frequent in the follow-up after discharge sample. The differences between the HADS outcomes of hospitalized and community patients were nonsignificant but remained beyond cutoff for more than 50% of follow-up patients.

Conclusion: The study highlights the importance of mood assessments for all stroke patients. The percentage of patients with residual psychological problems was lower than that reported in the literature. However, it is highly recommended for those patients with chronic poststroke psychological distress to have access to specialist psychological interventions.