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Original ArticleOpen Access
Anxiety and Depressive Symptoms after Stroke in 9 Rehabilitation Centers
Masskulpan P 
,
Riewthong K ,
Dajpratham P ,
Kuptniratsaikul V
,
Riewthong K ,
Dajpratham P ,
Kuptniratsaikul V Objective: Determine the occurrence of anxiety and depressive symptoms in rehabilitation phase and identify
the associated factors that include impact on functional outcome and quality of life in stroke patients.
Design: Prospective analytical study.
Material and Method: Two hundred fifty one stroke patients from nine rehabilitation centers admitted between
March and December 2006 were enrolled into the present study. Anxiety and depressive symptoms were
evaluated in stroke patients using the Hospital Anxiety and Depressive Scales (HADS) twice, on admission
and at discharge to rehabilitation program. Factors associated with anxiety and depressive symptoms were
identified using univariate and multiple logistic regression analyses. Functional ability and quality of life
using Barthel ADL Index (BI) and WHOQOL-BREF questionnaires respectively were recorded and analyzed.
Results: Two hundred fifty one patients were assessed for anxiety and depressive symptoms using HADS. It was
found that 25.5% of the patients suffered from anxiety symptoms, 37.8% from depressive symptoms, and 17.5%
from both. Anxiety symptoms were associated with depressive symptoms (OR 5.49, 95%CI 2.89-10.43) and
negatively associated with dyslipidemia (OR 0.48, 95%CI 0.25-0.94). Depressive symptoms were related to
anxiety symptoms (OR 5.88, 95%CI 3.15-10.99) and female gender (OR 1.81, 95%CI 1.04-3.16). Patients with
anxiety and depressive symptoms had lower functional ability and quality of life than patients without symptoms
on admission and at discharge. After the rehabilitation program, patients without anxiety symptoms showed
improvement in functional outcome and QOL. However, patients with or without depression symptoms have
improvement in functional outcome after rehabilitation. However, patients without depressive symptoms showed
more items improvement in QOL than patients with depression.
Conclusion: Symptoms of anxiety and depression are common after stroke. They are correlated with each
other. Female gender also related to depressive symptoms. Patients with anxiety and depressive symptoms
have lower functional ability and quality of life than those without symptoms.
Keywords: Anxiety, Depression, Stroke, Rehabilitation
the associated factors that include impact on functional outcome and quality of life in stroke patients.
Design: Prospective analytical study.
Material and Method: Two hundred fifty one stroke patients from nine rehabilitation centers admitted between
March and December 2006 were enrolled into the present study. Anxiety and depressive symptoms were
evaluated in stroke patients using the Hospital Anxiety and Depressive Scales (HADS) twice, on admission
and at discharge to rehabilitation program. Factors associated with anxiety and depressive symptoms were
identified using univariate and multiple logistic regression analyses. Functional ability and quality of life
using Barthel ADL Index (BI) and WHOQOL-BREF questionnaires respectively were recorded and analyzed.
Results: Two hundred fifty one patients were assessed for anxiety and depressive symptoms using HADS. It was
found that 25.5% of the patients suffered from anxiety symptoms, 37.8% from depressive symptoms, and 17.5%
from both. Anxiety symptoms were associated with depressive symptoms (OR 5.49, 95%CI 2.89-10.43) and
negatively associated with dyslipidemia (OR 0.48, 95%CI 0.25-0.94). Depressive symptoms were related to
anxiety symptoms (OR 5.88, 95%CI 3.15-10.99) and female gender (OR 1.81, 95%CI 1.04-3.16). Patients with
anxiety and depressive symptoms had lower functional ability and quality of life than patients without symptoms
on admission and at discharge. After the rehabilitation program, patients without anxiety symptoms showed
improvement in functional outcome and QOL. However, patients with or without depression symptoms have
improvement in functional outcome after rehabilitation. However, patients without depressive symptoms showed
more items improvement in QOL than patients with depression.
Conclusion: Symptoms of anxiety and depression are common after stroke. They are correlated with each
other. Female gender also related to depressive symptoms. Patients with anxiety and depressive symptoms
have lower functional ability and quality of life than those without symptoms.
Keywords: Anxiety, Depression, Stroke, Rehabilitation
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