Factors influencing self-reported anxiety or depression following stroke or TIA using linked registry and hospital data

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Purpose: Approximately 30–50% of survivors experience problems with anxiety or depression post-stroke. It is important to understand the factors associated with post-stroke anxiety or depression to identify effective interventions. Methods: Patient-level data from the Australian Stroke Clinical Registry (years 2009–2013), from participating hospitals in Queensland (n = 23), were linked with Queensland Hospital Emergency and Admission datasets. Self-reported anxiety or depression was assessed using the EQ-5D-3L, obtained at 90–180 days post-stroke. Multivariable multilevel logistic regression, with manual stepwise elimination of variables, was used to investigate the association between self-reported anxiety or depression, patient factors and acute stroke processes of care. Comorbidities, including prior mental health problems (e.g. anxiety, depression and dementia) coded in previous hospital admissions or emergency presentations using ICD-10 diagnosis codes, were identified from 5 years prior to stroke event. Results: 2853 patients were included (median age 74; 45% female; 72% stroke; 24% transient ischaemic attack). Nearly half (47%) reported some level of anxiety or depression post-stroke. The factors most strongly associated with anxiety or depression were a prior diagnosis of anxiety or depression [Adjusted Odds Ratio (aOR) 2.37, 95% confidence interval (95% CI) 1.66–3.39; p < 0.001], dementia (aOR 1.91, 95% CI 1.24–2.93; p = 0.003), being at home with support (aOR 1.41, 95% CI 1.12–1.69; p = < 0.001), and low socioeconomic advantage compared to high (aOR 1.59, 95% CI 1.21–2.10; p = 0.001). Acute stroke processes of care were not independently associated with anxiety or depression. Conclusions: Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.

Original languageEnglish
Pages (from-to)3145-3155
Number of pages11
JournalQuality of Life Research
Volume27
Issue number12
DOIs
Publication statusPublished - Dec 2018

Keywords

  • Anxiety
  • Comorbidity
  • Data linkage
  • Depression
  • Quality of life
  • Registries
  • Stroke

Cite this

@article{bdbbf006dace48baa5742a561416a5dd,
title = "Factors influencing self-reported anxiety or depression following stroke or TIA using linked registry and hospital data",
abstract = "Purpose: Approximately 30–50{\%} of survivors experience problems with anxiety or depression post-stroke. It is important to understand the factors associated with post-stroke anxiety or depression to identify effective interventions. Methods: Patient-level data from the Australian Stroke Clinical Registry (years 2009–2013), from participating hospitals in Queensland (n = 23), were linked with Queensland Hospital Emergency and Admission datasets. Self-reported anxiety or depression was assessed using the EQ-5D-3L, obtained at 90–180 days post-stroke. Multivariable multilevel logistic regression, with manual stepwise elimination of variables, was used to investigate the association between self-reported anxiety or depression, patient factors and acute stroke processes of care. Comorbidities, including prior mental health problems (e.g. anxiety, depression and dementia) coded in previous hospital admissions or emergency presentations using ICD-10 diagnosis codes, were identified from 5 years prior to stroke event. Results: 2853 patients were included (median age 74; 45{\%} female; 72{\%} stroke; 24{\%} transient ischaemic attack). Nearly half (47{\%}) reported some level of anxiety or depression post-stroke. The factors most strongly associated with anxiety or depression were a prior diagnosis of anxiety or depression [Adjusted Odds Ratio (aOR) 2.37, 95{\%} confidence interval (95{\%} CI) 1.66–3.39; p < 0.001], dementia (aOR 1.91, 95{\%} CI 1.24–2.93; p = 0.003), being at home with support (aOR 1.41, 95{\%} CI 1.12–1.69; p = < 0.001), and low socioeconomic advantage compared to high (aOR 1.59, 95{\%} CI 1.21–2.10; p = 0.001). Acute stroke processes of care were not independently associated with anxiety or depression. Conclusions: Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.",
keywords = "Anxiety, Comorbidity, Data linkage, Depression, Quality of life, Registries, Stroke",
author = "Tharshanah Thayabaranathan and Andrew, {Nadine E.} and Kilkenny, {Monique F.} and Rene Stolwyk and Thrift, {Amanda G.} and Rohan Grimley and Trisha Johnston and Vijaya Sundararajan and Lannin, {Natasha A.} and Cadilhac, {Dominique A.}",
year = "2018",
month = "12",
doi = "10.1007/s11136-018-1960-y",
language = "English",
volume = "27",
pages = "3145--3155",
journal = "Quality of Life Research",
issn = "0962-9343",
publisher = "Springer",
number = "12",

}

TY - JOUR

T1 - Factors influencing self-reported anxiety or depression following stroke or TIA using linked registry and hospital data

AU - Thayabaranathan, Tharshanah

AU - Andrew, Nadine E.

AU - Kilkenny, Monique F.

AU - Stolwyk, Rene

AU - Thrift, Amanda G.

AU - Grimley, Rohan

AU - Johnston, Trisha

AU - Sundararajan, Vijaya

AU - Lannin, Natasha A.

AU - Cadilhac, Dominique A.

PY - 2018/12

Y1 - 2018/12

N2 - Purpose: Approximately 30–50% of survivors experience problems with anxiety or depression post-stroke. It is important to understand the factors associated with post-stroke anxiety or depression to identify effective interventions. Methods: Patient-level data from the Australian Stroke Clinical Registry (years 2009–2013), from participating hospitals in Queensland (n = 23), were linked with Queensland Hospital Emergency and Admission datasets. Self-reported anxiety or depression was assessed using the EQ-5D-3L, obtained at 90–180 days post-stroke. Multivariable multilevel logistic regression, with manual stepwise elimination of variables, was used to investigate the association between self-reported anxiety or depression, patient factors and acute stroke processes of care. Comorbidities, including prior mental health problems (e.g. anxiety, depression and dementia) coded in previous hospital admissions or emergency presentations using ICD-10 diagnosis codes, were identified from 5 years prior to stroke event. Results: 2853 patients were included (median age 74; 45% female; 72% stroke; 24% transient ischaemic attack). Nearly half (47%) reported some level of anxiety or depression post-stroke. The factors most strongly associated with anxiety or depression were a prior diagnosis of anxiety or depression [Adjusted Odds Ratio (aOR) 2.37, 95% confidence interval (95% CI) 1.66–3.39; p < 0.001], dementia (aOR 1.91, 95% CI 1.24–2.93; p = 0.003), being at home with support (aOR 1.41, 95% CI 1.12–1.69; p = < 0.001), and low socioeconomic advantage compared to high (aOR 1.59, 95% CI 1.21–2.10; p = 0.001). Acute stroke processes of care were not independently associated with anxiety or depression. Conclusions: Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.

AB - Purpose: Approximately 30–50% of survivors experience problems with anxiety or depression post-stroke. It is important to understand the factors associated with post-stroke anxiety or depression to identify effective interventions. Methods: Patient-level data from the Australian Stroke Clinical Registry (years 2009–2013), from participating hospitals in Queensland (n = 23), were linked with Queensland Hospital Emergency and Admission datasets. Self-reported anxiety or depression was assessed using the EQ-5D-3L, obtained at 90–180 days post-stroke. Multivariable multilevel logistic regression, with manual stepwise elimination of variables, was used to investigate the association between self-reported anxiety or depression, patient factors and acute stroke processes of care. Comorbidities, including prior mental health problems (e.g. anxiety, depression and dementia) coded in previous hospital admissions or emergency presentations using ICD-10 diagnosis codes, were identified from 5 years prior to stroke event. Results: 2853 patients were included (median age 74; 45% female; 72% stroke; 24% transient ischaemic attack). Nearly half (47%) reported some level of anxiety or depression post-stroke. The factors most strongly associated with anxiety or depression were a prior diagnosis of anxiety or depression [Adjusted Odds Ratio (aOR) 2.37, 95% confidence interval (95% CI) 1.66–3.39; p < 0.001], dementia (aOR 1.91, 95% CI 1.24–2.93; p = 0.003), being at home with support (aOR 1.41, 95% CI 1.12–1.69; p = < 0.001), and low socioeconomic advantage compared to high (aOR 1.59, 95% CI 1.21–2.10; p = 0.001). Acute stroke processes of care were not independently associated with anxiety or depression. Conclusions: Identification of those with prior mental health problems for early intervention and support may help reduce the prevalence of post-stroke anxiety or depression.

KW - Anxiety

KW - Comorbidity

KW - Data linkage

KW - Depression

KW - Quality of life

KW - Registries

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=85051491491&partnerID=8YFLogxK

U2 - 10.1007/s11136-018-1960-y

DO - 10.1007/s11136-018-1960-y

M3 - Article

VL - 27

SP - 3145

EP - 3155

JO - Quality of Life Research

JF - Quality of Life Research

SN - 0962-9343

IS - 12

ER -