Assessment of Anxiety and Depressive Symptoms in the Early Post-stroke Period

There is some evidence suggesting an association between cerebrovascular diseases and the development of depression on the one hand, and between depression and post-stroke recovery on the other. Post-stroke depression can occur in the early post-stroke period or in the later stages of recovery (over 9 months after the incident).

To find a connection between stroke and the development of anxiety and depression in the early period after the development of neurological deficit and to evaluate several scales for their potential usefulness in the screening of post-stroke patients for early signs of depression and anxiety.

We conducted a study on the presence of depression in 117 patients, divided into 2 groups: 73 of these patients were admitted due to ischemic stroke, while the other 44 were controls matching the patients in age, sex and education status. The inclusion and exclusion criteria were defined clearly. We included patients that consented to undergo psychiatric evaluation be-tween 24 hours and 7 days after the onset of neurological symptoms. Both groups were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), Hospital Anxiety and Depression Scale - Depression Subscale and Combined Scale (HADS-D, HADS-T).

On evaluation with HADS-D we noted the largest difference between the two groups with a very high statistical significance and a medium effect size (7.92±4.44 points vs. 4.86±4.27 points for the control group, p<0.001, r= -0.417). Anxiety and depressive symp-toms were found also with MADRS and HAM-A.

Anxiety and depressive symptoms were found in the early post-stroke period. MADRS, HADS-D, and HAM-A are suf-ficiently specific and sensitive in the evaluation of post-stroke anxiety and depression.