Quality of Life and Mood Disorders in Mild to Moderate Stroke Survivors in Acute Post Stroke Condition: A Cross-Sectional Study
Syed Aftab Husain Rizvi1, Anand Kumar2, Deepika Joshi2
1MBBS, 2Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
Objective:
Assessing Quality of Life (QoL) besides physical impairment is also important to analyse the post-stroke disability fully. In this study, we evaluated the clinical and psychosocial factors impacting the Post-stroke QoL and assessed their relationship with poor psychological adaptation.
Background:

Stroke affects QoL of patients owing to its related cognitive, physical and functional consequences, such as restrictions in mobility, language impairment and depression.

Design/Methods:

In this prospective, cross-sectional study, 30 patients of mild-moderate stroke within 7 days of onset were subjected to the Stroke Specific-Quality of Life (SS-QOL), Generalised Anxiety Disorder (GAD-7), Hospital Anxiety and Depression (HADS), Sleep Quality Scale (SQS), Barthel Index, NIHSS and mRS scoring. 

Results:

The participants reported mean SS-QOL of 112.37(IQR=86.75-131.50), Sleep Quality of 36.33(IQR=29.00-44.00) and Barthel Index of 20.33(IQR=0.00-30.00). More than half of patients (60%,n=18) had moderate-severe anxiety while 83.33% (n=25) had depression (GAD>10). SS-QOL significantly correlated with NIHSS(p=0.018), mRS(p=0.001) and the ICH scale(p=0.022).  Anxiety levels were significantly correlated with NIHSS(p=0.025). More severe anxiety was seen in Ischemic as compared to Haemorrhagic stroke (p=0.04). Patients with poor sleep (SQS>39) had higher odds of developing anxiety (OR=17.286) and poor QOL(OR=13). Males had lower odds of developing anxiety (OR=0.127). Depression in patients was significantly correlated with the mRS score(p=0.002). The presence of atrial fibrillation(p=0.038), being dependent(p=0.028) and incontinent(p=0.028) was significantly associated with development of depression. The development of mood disorders was strongly correlated with poor SS-QOL (p<0.0001). Patients with poor sleep more likely had an overall poor SS-QOL(p=0.001).

Conclusions:

The above results emphasise that a significant number of immediate post-stroke patients suffer from anxiety, depression and mood disorders. Hence, treatment for these psychological conditions should also be addressed along with the standard treatment of care and rehabilitation for stroke to improve the QOL of the survivor and ensure their optimal recovery.

10.1212/WNL.0000000000210358
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