Original Research Article
Year: 2018 | Month: April | Volume: 8 | Issue: 4 | Pages: 16-23
Prevalence and Factors Influencing Anxiety in Patients with Stroke Attending a Tertiary Care Teaching Hospital, a Cross Sectional Study
Dr. Pavan kumar TV1*, Dr. Shaik Afsar Pasha1**, Dr. Chaitanya Ch2*
1Associate Professor, 2Senior Resident,
*Department of Psychiatry, **Department of Neurology,
NRI Medical College and General Hospital, Chinakakani, Guntur District, Andhra Pradesh, India 522503.
Corresponding Author: Dr. Shaik Afsar Pasha
Background: The incidence rate of stroke in Low and Middle Income Countries (LMICs) has increased. There has been a decrease in the stroke incidence in high-income countries (HICs) indicating approximately 42 percent decrease in stroke incidence in HICs and more than double increase in stroke incidence in LMICs, during the past four decades. India has been experiencing significant demographic, economic and epidemiological transition during the past two decades. These have resulted in an increase in life expectancy and consequently an increase in ageing population. Higher anxiety levels are associated prospectively with increased risk for incident stroke independent of other risk factors. Anxiety is a modifiable experience that is highly prevalent among the general population. The current study assesses the factors influencing anxiety in stroke patients (Post-stroke anxiety-PSA).
Materials & methods: This cross sectional study was conducted in the Department of Neurology and the Department of Psychiatry in NRI General Hospital, located in Andhra Pradesh, South India. The study had included 98 eligible stroke patients and evaluated them for anxiety using Hamilton Anxiety Rating Scale (HAM-A).
Results: The prevalence of anxiety was high (18.4%) among stroke patients (Post-stroke anxiey-PSA), out of which 11.2% had mild anxiety, 5.1% had moderate anxiety and 2% had severe anxiety. After controlling for all the other factors in the multivariate analysis, the odds of anxiety are 4.839 times increase in middle class (Odds ratio 4.839, 95% CI 1.049 to 22.327, P value 0.043), which was statistically significant. The odds of anxiety were 7.809 times increase in high class (Odds ratio 7.809, 95% CI 1.067 to 57.158, P value 0.043), which was statistically significant. Presence of UMN facial palsy was also independently associated with increased risk of stroke in study population, (Odds ratio=5.037, 95% CI 1.424 to 17.816, P value=0.012) which was statistically significant. The factors which had no statistically significant association with stroke were, age of the person, gender, education, family type, presence of aphasia and presence of stressful life event.
Conclusions: The prevalence of anxiety was high among stroke patients. Health care providers treating stroke patients at different levels should be sensitized regarding this and there is a need to develop appropriate interventions to deal with Post-stroke anxiety (PSA) patients.
Key words: Ischemic stroke, anxiety, stressful life event.