Fure Brynjar, Wyller Torgeir Bruun, Engedal Knut, Thommessen Bente
Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway.
Int J Geriatr Psychiatry. 2006 Apr;21(4):382-7. doi: 10.1002/gps.1482.
Anxiety and depressive symptoms encountered in acute stroke influence the patients' neurological outcome and the psychosocial burden of family members. These emotional changes may be caused by the patients' brain damage per se or by psychological reactions. The aims of the present study were to assess the prevalence of anxiety and depressive symptoms in the acute stage of ischemic stroke, and to identify the factors associated with such problems.
Anxiety and depressive symptoms were evaluated in 178 patients with acute ischemic stroke using the Hospital Anxiety and Depression Scale (HADS) between day 3 and 7 after admittance to the stroke unit. Factors associated with anxiety and depressive symptoms were identified using logistic regression analyses.
26.4% of the patients suffered from anxiety symptoms, 14.0% from depressive symptoms and 7.9% from both. Anxiety symptoms were associated with single marital state (OR 2.53, 95% CI 1.18-5.41) and a low Mini Mental State Examination (MMSE) score (< 26 points) (OR 0.53, 95% CI 0.31-0.87) whereas depressive symptoms were related to a low Barthel Activities of Daily Living index (BI) (score < 90 points) (OR 0.37, 95% CI 0.15-0.88).
The present study indicates that anxiety symptoms are more frequent than depressive symptoms in the acute stage of ischemic stroke. It is important to focus on both anxiety and depressive symptoms throughout the rehabilitation phase in order to ease the patients' personal anguish and improve neurological outcome after stroke.
急性卒中时出现的焦虑和抑郁症状会影响患者的神经功能预后以及家庭成员的心理社会负担。这些情绪变化可能由患者本身的脑损伤或心理反应引起。本研究的目的是评估缺血性卒中急性期焦虑和抑郁症状的患病率,并确定与此类问题相关的因素。
在178例急性缺血性卒中患者入住卒中单元后第3至7天,使用医院焦虑抑郁量表(HADS)评估焦虑和抑郁症状。采用逻辑回归分析确定与焦虑和抑郁症状相关的因素。
26.4%的患者有焦虑症状,14.0%有抑郁症状,7.9%两者皆有。焦虑症状与单身婚姻状况(比值比[OR]2.53,95%置信区间[CI]1.18 - 5.41)和简易精神状态检查表(MMSE)得分低(<26分)(OR 0.53,95%CI 0.31 - 0.87)相关,而抑郁症状与巴氏日常生活活动指数(BI)低(得分<90分)(OR 0.37,95%CI 0.15 - 0.88)有关。
本研究表明,缺血性卒中急性期焦虑症状比抑郁症状更常见。在整个康复阶段关注焦虑和抑郁症状很重要,以便减轻患者的个人痛苦并改善卒中后的神经功能预后。