Stein Laura A, Goldmann Emily, Zamzam Ahmad, Luciano Jean M, Messé Steven R, Cucchiara Brett L, Kasner Scott E, Mullen Michael T
Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
College of Global Public Health, New York University, New York, NY, United States.
Front Neurol. 2018 Nov 2;9:890. doi: 10.3389/fneur.2018.00890. eCollection 2018.
Stroke patients are known to be at risk of developing anxiety, depression, and post-traumatic stress disorder (PTSD). To determine the overlap between anxiety, depression, and PTSD in patients after stroke and to determine the association between these disorders and quality of life, functional status, healthcare utilization, and return to work. A cross-sectional telephone survey was conducted to assess for depression, anxiety, PTSD, and health-related outcomes 6-12 months after first ischemic stroke in patients without prior psychiatric disease at a single stroke center. Of 352 eligible subjects, 55 (16%) completed surveys. Seven subjects (13%) met criteria for probable anxiety, 6 (11%) for PTSD, and 11 for depression (20%). Of the 13 subjects (24%) who met criteria for any of these disorders, 6 (46%) met criteria for more than one, and 5 (39%) met criteria for all three. There were no significant differences in baseline characteristics, including stroke severity or neurologic symptoms, between those with or without any of these disorders. Those who had any of these disorders were less likely to be independent in their activities of daily living (ADLs) (54 vs. 95%, < 0.001) and reported significantly worse quality of life (score of 0-100, median score of 50 vs. 80, < 0.001) compared to those with none of these disorders. Anxiety, depression, and PTSD are common after stroke, have a high degree of co-occurrence, and are associated with worse outcomes, including quality of life and functional status.
已知中风患者有患焦虑症、抑郁症和创伤后应激障碍（PTSD）的风险。目的是确定中风后患者焦虑症、抑郁症和创伤后应激障碍之间的重叠情况，并确定这些疾病与生活质量、功能状态、医疗保健利用和重返工作岗位之间的关联。在一个单一的中风中心，对首次发生缺血性中风且无既往精神疾病的患者进行了一项横断面电话调查，以评估首次缺血性中风后6至12个月的抑郁、焦虑、创伤后应激障碍和健康相关结局。在352名符合条件的受试者中，55名（16%）完成了调查。7名受试者（13%）符合可能焦虑症的标准，6名（11%）符合创伤后应激障碍的标准，11名（20%）符合抑郁症的标准。在符合这些疾病中任何一种标准的13名受试者（24%）中，6名（46%）符合不止一种标准，5名（39%）符合所有三种标准。有或没有这些疾病的患者在基线特征（包括中风严重程度或神经症状）方面没有显著差异。与没有这些疾病的患者相比，患有这些疾病中的任何一种的患者在日常生活活动（ADL）中不太可能独立（54%对95%，<0.001），并且报告的生活质量明显更差（0至100分，中位数得分50对80，<0.001）。焦虑症、抑郁症和创伤后应激障碍在中风后很常见，共病程度高，并且与包括生活质量和功能状态在内的更差结局相关。
