Need for Enhancing Mental Health Care in Stroke Patients: Insights Into Post-stroke Anxiety and Depression from the National Health Interview Survey (NHIS) Data
Nithin Kurra1, Nikhila Gandrakota2, Manju Ramakrishnan3, Alekhya Nimmagadda4, Sravani Konatham3, Prerana Sevella5, Dinesh Jillella6
1University of Nebraska Medical Center, 2Emory University School of Medicine, 3Emory University, 4Apollo Institute of Medical Sciences and Research, 5Jefferson Abington Hospital, 6Emory University School of Medicine / Grady Memorial Hospital
Background:
Stroke is a leading cause of chronic disability, with neuropsychiatric presentations being increasingly recognized as complications that hinder rehabilitation and patient outcomes. This study investigates factors influencing anxiety and depression prevalence in stroke patients.
Design/Methods:
Utilizing 2019 National Health Interview Survey (NHIS) data, we conducted chi-square tests and multivariate logistic regression models, adjusting for various factors. We also assessed the proportion of anxiety and depression patients undergoing therapy and/or medication.
Results:
There were 1204 (N=7,745,925) participants with stroke and 30,743 (N=242,831,595) without stroke. After applying appropriate sample weights, we identified that patients aged 65-75 and >=75 had similar odds but demonstrated decreased likelihood of depression compared to younger patients with stroke (OR=0.4, 95%CI (0.2,0.9). Moreover, stroke patients with high school education or higher were less likely to have anxiety (OR=0.6, 95%CI (0.4,0.9) while patients with medicare/medicaid were more likely to have anxiety (OR=2.9, 95% CI (1.1,7.7) after adjusting for demographic factors. Therapy use was suboptimal with only 24.2% and 43.4% of stroke patients with mild-moderate and severe anxiety, respectively, currently receiving therapy. For depression, therapy was sought by only 20.0% and 35.9% with mild/moderate and severe depression, respectively. Furthermore, medication use was noted in 42.6% and 48.4% of patients with stroke with mild-moderate and severe anxiety, respectively while 35.3% and 59.3% of stroke patients with mild-moderate and severe depression were taking medication
Conclusions:
Demographic factors were found to significantly affect the prevalence of anxiety and depression among stroke patients with sub-optimal utilization of therapy and treatment. Appropriate guidelines are necessary for routine screening and treatment of anxiety and depression among stroke patients.