Cardiff University /Cardiff and Vale University Health Board, Clinical Psychology Training, Archway House, Llanishen, Cardiff, UK.
Disabil Rehabil. 2012;34(9):733-9. doi: 10.3109/09638288.2011.619623. Epub 2011 Oct 17.
This article examines practical approaches to increasing rates of screening for depression and anxiety in hospital-based stroke services.
The literature on depression and anxiety following stroke is briefly reviewed together with evidence relating to screening. A small-scale trial of an educational and support package to improve screening rates compared 30 consecutive admissions before and after the intervention. An extended commentary on the outcome considered alternative approaches to improving screening.
The literature review confirmed that depression after stroke has multiple adverse effects and that screening is not universally applied. There has been less research into anxiety after stroke, but it is likely that anxiety screening is also incomplete. The trial of the intervention to promote screening demonstrated strong trends towards improvement for depression (23.3%; odds ratio 2.67; χ(2) p = 0.067) and a trend for anxiety (16.7%; odds ratio 1.96; χ(2) p = 0.20).
Education and training about depression and anxiety screening and access to screening materials improved rates of screening to a limited degree. An extended commentary explored how screening rates might be further improved by considering the intervention strategy, the staffing model, the training approach and the screening methods themselves. Finally, consideration is given to treatment approaches for mood disorders.
本文探讨了在医院脑卒中服务中提高抑郁和焦虑筛查率的实用方法。
简要回顾了脑卒中后抑郁和焦虑的文献，以及与筛查相关的证据。一项关于教育和支持包以提高筛查率的小型试验，比较了干预前后的 30 例连续入院。对结果的扩展评论考虑了改善筛查的其他方法。
文献综述证实，脑卒中后抑郁有多种不良影响，而且筛查并未普遍应用。对于脑卒中后焦虑的研究较少，但焦虑筛查可能也不完整。促进筛查的干预试验表明，抑郁（23.3%；优势比 2.67；χ²p=0.067）和焦虑（16.7%；优势比 1.96；χ²p=0.20）的筛查率有明显改善的趋势。
关于抑郁和焦虑筛查的教育和培训以及获得筛查材料在一定程度上提高了筛查率。扩展评论探讨了如何通过考虑干预策略、人员配备模式、培训方法和筛查方法本身来进一步提高筛查率。最后，考虑了心境障碍的治疗方法。
