The Correlation Of Clinical Feature And Related Factors In Patients With Acute Cerebral Accident Comorbid Anxiety And Depression

Background There are seventy millions of patients who are suffering acute cerebral accident which called the aged follower in China.Among them,about 2/3 patient have residual disability,which makes family and society serious burden.Patients with stroke have not only functional disturbance,but also abnormal mental state,because brain integrity was destruction, which can result in anxious and depressive disorder.Anxious and depressive disorders make clinical cure and recovery more difficulty,to prolong in hospitial days and add medical expenses. Clinicians pay close attention to post-stroke anxiety and depressive as communication-consultation psychiatry develops in the general hospitals.But there is a trifle of research with post-stroke comorbid anxiety and depression(PSCAD).So we should pay more recognition and carry out screening with this emotional disorder,in order to identify and intervent,reduce mutilation module,decrease the burden of the familes and sociaty.Objective To investigate the incidence of anxiety-depression,clinical feature and related factor in patients with acute cerebral accident,provide a few helps for earlier diagnossis and intervention with this post-stroke emotional disturbance.Methods Case-control study was used.The patients come from the Neurology Department of NO.3,the people's hospital of Datong,during May 2006 to December 2007.The patientis are older than thirty years,suffering cerebral infarction or hemarrage more than two weeks,confirmed by neuroradiological CT or MR scan.When patients admitted,we collected their detailed case history,filled in general questionnaire,Hamilton Anxiety Scale,Hamilton Despressive Scale,neurologic impairment degree scale,Socoal support Scale,Ways of coping questionnaire,the data of related lab test and clinical examination.After two weeks,psychiatric, neurologic assessment,social support and the ways of coping questionnaire were performed by two profesional doctors.We used Hamilton Anxiety Scale and Hamilton Depressive Scale to measure anxiety and depressive disorder.If the patient's HAMA score is≥14 and HAMD score is≥7,he could be diagnosed anxiety -depressive disorder.We used the single factor analysis to screening the expose factor.All data were statistically analyzed with the SPSS 11.5 software package by using the t test,chi-square test and stepwise regression analysis.Significance level was set as P＜0.05(both sides).Results Total 82 patients were investigated and all the enrolled subjects were involved in the final analysis of results.In the 82 participants,there were 55 males and 27 femals and the average age is 57.77±12.14(35-84).The frequency of post-stroke anxiety -depressive disorder was 26.8%(n=22).By single factor analysis with post-stroke anxiety -depressive disorder,we found there is statistical significance in anxious history,number of focus,the degree of neurologic impairment,social support,the ways to deal with.According to the multiple logistic regression model,all of those factors are correlated with the occurrence of post-stroke anxiety -depressive disorder.Conclusion The degree ofneurologic impairment and the passive way to deal with are the risk factors of PSCAD,while the social support and the active way to deal with are the protective factors of PSCAD.The history of anxiety,two or more than two foci are correlated with the diagnosis of PSCAD.There were no statistically significant differences in sex,age,stroke type, stroke localization,occupation,habitation,educational background,high blood pressure(HBP), diabetes,coronary artery disease(CAD).