Maaijwee N A M M, Tendolkar I, Rutten-Jacobs L C A, Arntz R M, Schaapsmeerders P, Dorresteijn L D, Schoonderwaldt H C, van Dijk E J, de Leeuw F-E
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Eur J Neurol. 2016 Aug;23(8):1262-8. doi: 10.1111/ene.13009. Epub 2016 Apr 20.
Few studies exist on long-term post-stroke depressive symptoms and anxiety in young adults, although these young patients have a particular interest in their long-term prognosis, given their usually long life expectancy and being in the midst of an active social, working and family life. The aims of this study were to investigate the prevalence of depressive symptoms and anxiety and their association with clinical and demographic variables and with functional outcome after stroke in young adults.
Long-term prevalence of depressive symptoms and anxiety was calculated in 511 patients with a transient ischaemic attack or ischaemic stroke, aged 18-50 years, using the Hospital Anxiety and Depression scale, compared with 147 controls. Functional outcome was assessed with the modified Rankin Score (mRS) and the Instrumental Activities of Daily Living scale (IADL). 16.8% of patients had depressive symptoms and 23.0% had anxiety, versus 6.1% (P = 0.001) and 12.2% (P < 0.001) in controls. In ischaemic stroke patients, depressive symptoms and anxiety were associated with poor functional outcome (mRS > 2 or IADL < 8).
Even a decade after stroke at young age, depressive symptoms and anxiety were prevalent and associated with poor functional outcome. Therefore, even in the long term, treating physicians should be aware of the long-term presence of these symptoms as their recognition may be the first step in improving long-term functional independence.
尽管年轻的中风患者由于通常预期寿命较长且处于活跃的社交、工作和家庭生活中，对其长期预后特别关注，但关于年轻成年人中风后长期抑郁症状和焦虑的研究较少。本研究的目的是调查年轻成年人中风后抑郁症状和焦虑的患病率，以及它们与临床和人口统计学变量以及功能结局的关联。
使用医院焦虑抑郁量表计算了511例年龄在18 - 50岁的短暂性脑缺血发作或缺血性中风患者的抑郁症状和焦虑的长期患病率，并与147名对照者进行比较。使用改良Rankin量表（mRS）和日常生活活动能力量表（IADL）评估功能结局。16.8%的患者有抑郁症状，23.0%的患者有焦虑，而对照组分别为6.1%（P = 0.001）和12.2%（P < 0.001）。在缺血性中风患者中，抑郁症状和焦虑与功能结局不良（mRS > 2或IADL < 8）相关。
即使在年轻时中风十年后，抑郁症状和焦虑仍然普遍存在，并且与功能结局不良相关。因此，即使从长期来看，治疗医生也应意识到这些症状的长期存在，因为认识到这些症状可能是改善长期功能独立性的第一步。
