Effect on anxiety and depression of a multifactorial risk factor intervention program after stroke and TIA: a randomized controlled trial.
OBJECTIVES
Depression and anxiety related to stroke are caused by vascular lesions and psychological reactions. Treatment of vascular and modifiable behavioral risk factors reduces the risk of stroke and may also reduce the risk of emotional changes after stroke. We aimed to investigate whether a multifactorial risk factor intervention program in patients with first-ever stroke or transient ischemic attack (TIA) can influence post-stroke anxiety and depressive symptoms in patients one year post-stroke.


METHOD
The study population consisted of first-ever stroke and TIA patients allocated in a randomized, evaluator-blinded, controlled trial to care as usual or a structured and multidisciplinary follow-up including intensive treatment of vascular risk. The primary endpoint (cognition) has previously been reported. The secondary endpoint, reported here, was changes in the Hospital Anxiety and Depression Scale (HADS) from baseline to 12-month follow-up.


RESULTS
One hundred and ninety-five patients were randomized. The estimated difference between treatment groups, in changes in HADS, from baseline to 12 months was -1.32 (95% confidence interval: -2.61, -0.04; P = 0.044) in favor of the intervention group. One year post-stroke, 4/85 (4.7%) patients in the intervention group and 12/89 (13.5%) in the control group suffered from depression (P = 0.045), while 7/85 (8.2%) patients in the intervention group and 13/89 (14.6%) patients in the control group suffered from anxiety (P = 0.19).


CONCLUSION
A structured, multidisciplinary, multifactorial risk factor program including vascular risk factor management may be associated with reduced HADS scores and a lower prevalence of depressive symptoms one year after stroke.
['Ihle-Hansen|Hege|H|', 'Thommessen|Bente|B|', 'Fagerland|Morten Wang|MW|', 'Oksengård|Anne Rita|AR|', 'Wyller|Torgeir Bruun|TB|', 'Engedal|Knut|K|', 'Fure|Brynjar|B|']
D000368:Aged D001007:Anxiety D003863:Depression D005260:Female D006801:Humans D002546:Ischemic Attack, Transient D008297:Male D010348:Patient Care Team D011569:Psychiatric Status Rating Scales D012307:Risk Factors D040242:Risk Reduction Behavior D016037:Single-Blind Method D020521:Stroke D000071939:Stroke Rehabilitation
anxiety depression anxiety and trauma related disorders mood disorders psychosocial interventions training and educational programs