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短暂性脑缺血发作和脑卒中急性期创伤后应激症状、焦虑和抑郁的发生情况。

Occurence of Post-Traumatic Stress Symptoms, Anxiety and Depression in the Acute Phase of Transient Ischemic Attack and Stroke.

机构信息

Universitätsklinikum Bonn AöR, Klinik und Poliklinik für Psychiatrie, Bonn, Germany.

Faculty of Health/School of Medicine, Integrative Psychiatry and Psychotherapy, Witten/Herdecke University, Witten, Germany.

出版信息

Psychiatr Q. 2021 Sep;92(3):905-915. doi: 10.1007/s11126-020-09873-9. Epub 2021 Jan 2.

Abstract

Rates of post-traumatic stress symptoms, anxiety and depression are increased in patients having experienced a transient ischemic attack (TIA) or stroke several months ago. However, data of psychiatric symptoms in the acute phase within the first days after ictus are lacking. In 20 patients with stroke and 33 patients with TIA we assessed disease severity by means of the NIHSS, levels of depression and anxiety by HADS, PTSD-like symptoms by PC-PTSD, quality of life (HrQoL) by SF-12, and coping style by brief COPE Inventory within the first 5 days after ictus. NIHSS on admission was lower in patients with TIA (0 ± 1) than in patients with stroke (3 ± 2, p < 0.001). HADS depression score was significantly higher in patients with stroke (7.0 ± 4.5) than in patients with TIA (4.9 ± 4.0). HADS anxiety score, HrQoL and coping styles were similar between TIA and stroke patients (p > 0.05). 5 and 3 of 33 TIA patients as well as 4 and 3 of 20 stroke patients had at least 11 points in the HADS anxiety and depression score respectively (p = 0.001). 2 of 33 TIA patients and 2 of 20 stroke patients had more than 2 points in the PC-PTSD (p = 0.646). We did not find consistent correlations between the NIHSS and the psychometric parameters. Within the first five days after patients having experienced a TIA or stroke PTSD-like, anxious and depressive symptoms are more common than in the general population. As the acute psychological status after ictus is predictive for psychiatric comorbidity years later physicians should pay attention and adequately treat psychiatric symptoms already in the acute phase of stroke.Trial Registration: German Clinical Trials Register, DRKS00021730, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021730 , registered 05/19/2020- Retrospectively registered.

摘要

经历短暂性脑缺血发作(TIA)或中风几个月后的患者,其创伤后应激症状、焦虑和抑郁的发生率会增加。然而,在中风发作后的最初几天内,有关急性期精神症状的数据尚缺乏。在 20 例中风患者和 33 例 TIA 患者中,我们通过 NIHSS 评估疾病严重程度,通过 HADS 评估抑郁和焦虑水平,通过 PC-PTSD 评估创伤后应激症状,通过 SF-12 评估生活质量(HrQoL),通过 brief COPE Inventory 评估应对方式,所有评估均在中风发作后的前 5 天内进行。发病时,TIA 患者的 NIHSS 评分(0±1)低于中风患者(3±2,p<0.001)。中风患者的 HADS 抑郁评分(7.0±4.5)显著高于 TIA 患者(4.9±4.0)。TIA 和中风患者的 HADS 焦虑评分、HrQoL 和应对方式相似(p>0.05)。33 例 TIA 患者中有 5 例和 20 例中风患者中有 3 例 HADS 焦虑和抑郁评分至少为 11 分(p=0.001)。33 例 TIA 患者中有 2 例和 20 例中风患者中有 2 例 PC-PTSD 评分超过 2 分(p=0.646)。我们未发现 NIHSS 与心理计量学参数之间存在一致性相关性。在经历 TIA 或中风后的最初五天内,创伤后应激、焦虑和抑郁症状比一般人群更为常见。由于中风后急性期的心理状态可预测多年后的精神共病,因此医生应在中风的急性期就注意并充分治疗精神症状。

试验注册

德国临床试验注册处,DRKS00021730,https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021730,注册于 2020 年 5 月 19 日-回顾性注册。

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