Ahmed Zakaria M, Khalil Mohamed F, Kohail Ahmed M, Eldesouky Islam F, Elkady Ahmed, Shuaib Ashfaq
Neurology Department, Saudi German Hospital, Madinah, Saudi Arabia; Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Neurology Department, Saudi German Hospital, Madinah, Saudi Arabia; Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105315. doi: 10.1016/j.jstrokecerebrovasdis.2020.105315. Epub 2020 Sep 10.
Stroke is associated with a rise in post-stroke depression (PSD) and anxiety (PSA). In this study, we evaluated the impact of COVID-19 pandemic on the rates of PSD and PSA.
All stroke admissions to two hospitals in Saudi Arabia during two months were prospectively evaluated for PSD and PSA. NIHSS and serum TSH assessed on admission. PSD and PSA were evaluated using Hospital Anxiety and Depression Scale (HADS). Post-stroke disability was assessed by mRS, while social support assessed by Multidimensional Scale of Perceived Social Support (MSPSS).
Among 50 participants (28 males), clinically significant PSD was found in 36%, while PSA in 32%. PSD associated with higher NIHSS (P < 0.001); lower MSPSS (P = 0.003); higher mRS (P = 0.001); and discontinuation of rehabilitation (P = 0.02). PSA was associated with higher TSH (P = 0.01); lower MSPSS (P = 0.03); while discontinuation of rehabilitation was related to less PSA (P = 0.034). Multivariate analysis showed that NIHSS (OR: 1.58, 95% CI: 742-3.37; P = 0.01); and MSPSS score (OR: 0.66, 95% CI: 0.47-0.94; P = 0.002) were associated with PSD; while PSA was related to TSH level (OR: 8.32, 95% CI:1.42-47.23; P = 0.02), and discontinuation of rehabilitation (OR: -0.96, 95% CI: -1.90-0.02; P = 0.04).
Our research shows that the rise in PSD is related to stroke severity and this has not changed significantly during the pandemic; however, PSA showed a noticeable peak. Social deprivation and the lacking levels of rehabilitation related significantly to both.
中风与中风后抑郁(PSD)和焦虑(PSA)的增加有关。在本研究中,我们评估了新冠疫情对PSD和PSA发生率的影响。
对沙特阿拉伯两家医院两个月内收治的所有中风患者进行前瞻性PSD和PSA评估。入院时评估美国国立卫生研究院卒中量表(NIHSS)和血清促甲状腺激素(TSH)。使用医院焦虑抑郁量表(HADS)评估PSD和PSA。用改良Rankin量表(mRS)评估中风后残疾情况,而用领悟社会支持多维量表(MSPSS)评估社会支持。
在50名参与者(28名男性)中,36%存在具有临床意义的PSD,32%存在PSA。PSD与较高的NIHSS相关(P<0.001);较低的MSPSS相关(P=0.003);较高的mRS相关(P=0.001);以及康复治疗中断相关(P=0.02)。PSA与较高的TSH相关(P=0.01);较低的MSPSS相关(P=0.03);而康复治疗中断与较少的PSA相关(P=0.034)。多因素分析显示,NIHSS(比值比:1.58,95%置信区间:742 - 3.37;P=0.01)和MSPSS评分(比值比:0.66,95%置信区间:0.47 - 0.94;P=0.002)与PSD相关;而PSA与TSH水平相关(比值比:8.32,95%置信区间:1.42 - 47.23;P=0.02),以及康复治疗中断相关(比值比:-0.96,95%置信区间:-1.90 - 0.02;P=0.04)。
我们的研究表明,PSD的增加与中风严重程度有关,且在疫情期间这一情况未发生显著变化;然而,PSA出现了明显的峰值。社会剥夺和康复水平不足与两者均显著相关。