Clinical Analysis Of Anxiety And Depression In Post-stroke

BackgroundBrain apoplexy,is a local cerebrovascular disease which is characterized by acute onset,symptoms lasting more than 24 hours or direct lethality.Symptoms of a stroke include not only hemiplegia,aphasia,visual impairment and consciousness disorders,but also emotional and mental disorders.ObjectiveTo provide a better understanding of the role of emotional care and intervention in stroke patients.We investigated the factors of emotional disturbance in stroke patients by studying the status of depression and anxiety and analyzing life quality index,cognitive ability,interpersonal skills,family cohesion,adaptability to the current situation.MethodsThis was a simple random sampling study conducted between September 2015 and September 2016.197 stroke patients were collected as observation group from our hospital based on inclusion criteria.197 healthy people from our hospital physical examination center were taken as control group(group C)in the same period.Anxiety table(SAS)and Depression Scale(SDS)score were performed in all selected people.The observation group was divided into emotional disorder group(group A)and non emotional disorder group(group B)according to the scores.We analysed the variables of gender,age,occupation,education,household income,marital status,insurance,family relationship doctor-patient relationship and the lifestyle habits in terms of smoking,drinking,exercise,diet,sleep quality between the two groups.Together,we compared the scores between the two groups in activities of daily living,cognitive ability,social and family relationships.Results 1 In addition to blush(t=0.72,P=0.511),syncope(t=1.17,P=0.34)and tense(t=4.76,P=0.18),there was no significant difference between group A and group B.There was statistical difference in the scare of misfortune(t=20.02,P=0.000),helpless(t=7.82,P=0.001)chest tightness(t=37.25,P=0.002),afraid(t=5.29,P=0.004),,upset(t=6.88,P=0.000),crazy feeling(t=5.34,P=0.000),tremor(t=10.03,P=0.000),physical pain(t= 12.28,P=0.000)and so on.While The adverse events described previously did not differ between group B and group C.2 In the SDS scale in addition to morning heavy night light(t=4.76,P=0.18)and weight loss(t=0.36,P=0.234)and easy to tired(t=1.32,P=0.19),no significant differences,depression(t=57.31,P=0.000),easy to cry(t=12.66,P=0.000),sleep disorders(t=6.07,P=0.000),anorexia(t=18.23,P=0.000),constipation(t=9.83,P=0.003),palpitations(t=13.66,P=0.000),difficulty thinking(t=9.55,P=0.000),ability drops(t=12.60,P=0.000),restless(t=22.85,P=0.000),despair(t=22.06,P=0.000),irritable(t=5.64,P=0.000),difficult decisions(t=5.98,P=0.000),sense of void(t=34.06,P=0.000),sense of futility(t=38.78,P=0.000),no sense of value(t=26.26,P=0.000)and lost interest(t=22.98,P=0.000)were significantly different,with statistical significance between group A and group B.The adverse events described previously did not differ between group B and group C.3 The scores of SAS scale(t=16.88,P=0.000)and SDS scale(t=16.88,P=0.000)were significantly different between group A and group C,while group B was similar to group C.4 There was statistical difference in baseline characteristics and lifestyle habits between group A and group C(P<0.05),and no statistically significant differences were found between group B and group C(P > 0.05).5 Scales of activities of daily living(ADL)showed that there was statistical difference between group A and group B in 6 items,such as physical activity in the toilet(t=67.98,P=0.000),eating(t=37.40,P=0.000),dressing(t=9.20,P=0.000),wash comb(t=44.95,P=0.000).Also,there was significant difference in 8 items,such as making telephone calls in daily living(t=139.28,P=0.000),shopping(t=96.15,P=0.000),cooking(t=68.47,P=0.000),housework(t=64.78,P=0.000).6 MoCA total scores and all eight subscales scores were statistically increased in group A compared with group B(t=125.67,P=0.000),of these,group B was higher than group A in the aspects of visual space and executive function.7 There was statistical difference in interpersonal communication ability scale between group A and group B(t=65.44,P=0.000),and the scores of patients in group A were higher than cut-off score,and the mean scores were 184.99±59.86.8 Family cohesion and adaptability scores showed that there was statistical difference between group A and group B in aspects of family cohesion(t=61.53,P=0.000)and family adaptability(t=19.41,P=0.000).9 9 Compared with group B,group A showed significant linear correlation and linear regression relationship in quality of life of the scales,SAS scores,SDS scores and ADL scale,MOCA scale,family cohesion and adaptability scale.10 In a multiple linear regression analysis,the SAS and SDS scores in group A mainted a positive association with activities of daily living,cognitive ability,interpersonal communication ability,family cohesion and adaptability,respectively R=0.68,R2=0.47 and R=0.59,R2=0.35.Conclusions1?Gender,educational,family income,medical insurance,age,marital status,family relationship,health care,smoking habit,drinking habits,exercise habit,diet and sleep quality can significantly influence anxiety and depression in stroke patients.There was no significant correlation between occupation and eating well in post-stroke mood disorders.2?The activities of daily living,cognitive ability,interpersonal communication ability,family cohesion and adaptability showed significantly effect on anxiety and depression in stroke patients.3?Anxiety and depression are more frequent in stroke patients.There are many Influencing factors of anxiety and depression in post-stroke patients.