Assessment of Depression, Anxiety, Stress, Quality of Life, and Fatigue in Patients After a Cerebrovascular Accident

Cureus. 2024 Oct 21;16(10):e72051. doi: 10.7759/cureus.72051. eCollection 2024 Oct.

Abstract

Background A cerebrovascular accident, or stroke, is a neurological disorder. Those who suffer from a stroke not only face physical disabilities but also a range of psychological issues resulting from concerns about their current situation. The purpose of this study was to assess depression, anxiety, stress, and fatigue after a stroke, along with its effects on quality of life (QoL), degree of disability, and prevalence of various risk factors of stroke. Materials and methods Adult male and female patients who had experienced a stroke and came to the psychiatry or neurology outpatient departments were evaluated. A detailed stroke history was taken for them. The Stroke-Specific Quality of Life Scale (SSQOL) Scale, Depression Anxiety Stress Scale 21, Alcohol Use Disorders Identification Test C (AUDIT C) scale, Suicide Behaviors Questionnaire-Revised (SBQ-R) scale, Fatigue Severity Scale (FSS), and Modified Rankin Scale (mRS) were applied to assess the QoL, depression, anxiety, stress, alcohol use, suicidal behavior, fatigue, and the degree of disability, if any, after stroke. Results The study involved 100 stroke patients aged 18-60 years, with 82 males and 18 females. The mean age was 45.76 ± 8.54 years. 88% experienced an ischemic stroke, and 12% a hemorrhagic stroke. 68% had comorbidities, and alcohol use was present in 48% of patients. The QoL was lowest in the domains of social roles, upper extremity, family roles, and productivity. The study revealed that 67% of patients experienced depression, 63% anxiety, and 62% stress, with 40% having a high risk of suicidal behavior, 57% experiencing fatigue, and 67% disability. There was a significant positive correlation between lower QoL scores, higher depression, anxiety, stress, disability, suicidal ideation, fatigue, and factors such as increased age, female gender, recurrent stroke, psychiatric illness history, multiple comorbidities, and substance use. Conclusion Neuropsychiatric problems following a stroke are common and have serious consequences that significantly influence stroke survivors' QoL and ability to recover.

Keywords: alcohol; comorbidities; disability; neuropsychiatric problems; stroke.