Objective:

To examine psychiatric comorbidity among young hemorrhagic stroke survivors. 

Background:

Young hemorrhagic stroke survivors face increased risk of mental health concerns due to factors such as ICU hospitalization, chronic medical conditions, and brain injury, but research on the prevalence of psychiatric comorbidities among this population is limited. 

Design/Methods:

We conducted a retrospective chart review of 81 young hemorrhagic stroke survivors (ages 0-25) to assess for formal psychiatric diagnoses (active ICD-10 codes F01-F99 in the electronic medical record), evidence of psychiatric concerns without formal diagnoses (presence of pre-determined keywords, such as “anxiety” or “depression,” in the medical record), and evidence of psychiatric treatment (medications and/or mention of psychotherapy). We compared rates of psychiatric diagnoses or symptoms using multivariate logistic regression including the variables gender, age, age at stroke, time since stroke, pre-stroke neurologic comorbidities, and neurologic status at hospital discharge.

Results:

Of the 81 patients (median age at stroke: 9.47 years, median time since stroke: 3.37 years, 53% male, 51% Hispanic/Latino, 68% with AVM-related stroke), 73% had at least one documented psychiatric concern. Nearly two-thirds (62%) had a documented concern for anxiety or depression specifically. Formal psychiatric diagnoses were present in 37% of patients, including 22% with depression- or anxiety-related diagnoses. One third of patients (33%) received psychiatric medications or psychotherapy post-stroke. Patients with a neurologic deficit at hospital discharge were more likely to have documented psychiatric concerns (OR = 10.1, 95% CI = 2.3-56.9, p= 0.004). Patients with pre-stroke neurologic comorbidities were more likely to receive psychiatric medications or therapy (OR = 3.3, 95% CI = 1.0-11.0, p= 0.05). 

Conclusions:

A substantial proportion of this cohort of young hemorrhagic stroke survivors had formal psychiatric diagnoses or documented psychiatric concerns. Further research is needed to understand how psychiatric comorbidities and access to treatment may influence recovery after stroke.