Nearly half of patients with stroke live with mood disorders, often untreated
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Nearly half of people living with mood disorders such as anxiety and depression after stroke did not receive mental health treatment, and those being treated tend to only receive medication, researchers reported.
“Our results indicate that approximately 1 in 2 people living with stroke with self-reported anxiety/depression are not receiving mental health treatment, and those who do are mostly receiving medication only,” Priscilla Tjokrowijoto, PhD candidate at Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia, and colleagues wrote. “Health professionals should screen for mental health problems and introduce treatment options, with particular attention to individuals who are at risk of not receiving treatment.”
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The researchers analyzed 7,214 patients with stroke from the Australian Stroke Clinical Registry who completed a 3- to 6-month follow-up survey containing a question on anxiety/depression. Exposures were assessed at 6 to 18 months and outcomes were assessed at 18 to 30 months.
Among the cohort, 39% reported anxiety/depression in the 3 to 6 months following stroke, with 54% of those receiving treatment and 88% of those receiving treatment taking antidepressants. Factors associated with mental health treatment included pre-stroke psychological support (OR = 1.8; 95% CI, 1.37-2.38), or medication (OR = 17.58; 95% CI, 15.05-20.55), self-reported anxiety/depression (OR = 2.55; 95% CI, 2.24-2.9), younger age at stroke (OR = 0.98; 95% CI, 0.97-0.98) and being female (OR = 1.3; 95% CI, 1.13-1.48), the researchers wrote.
Patients who required interpreter services (OR = 0.49; 95% CI, 0.25-0.95), used a health care benefits card (OR = 0.73; 95% CI, 0.59-0.92) or showed continuity in their primary care visits, such as with a consistent physician (OR = 0.78; 95% CI, 0.62-0.99) were less likely to access mental health services, according to the researchers.
Those who received mental health treatment had elevated risk for presenting to the hospital (HR = 1.06; 95% CI, 1.01-1.11) but no difference in survival (HR = 1.04; 95% CI, 0.58-1.27) compared with individuals with mood disorders who did not receive treatment for them.
“Our results suggest that access to Medicare-funded chronic disease management plans, designed to support collaborative care based on the patient’s needs and goals, may facilitate mental health treatment,” Tjokrowijoto and colleagues wrote. “The holistic approach of these policies may provide opportunities to discuss mental health problems and develop appropriate action plans to manage identified needs.”
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