Anxiety and Depression in Stroke: An Evaluation of these Psychopathologies on Outcomes of Stroke Type using the National Inpatient Sample

BACKGROUND: Anxiety and depression have been reported to complicate the course of stroke. This study evaluated the association of anxiety and depression independently on ischemic vs non-ischemic stroke. METHODS: A cross-sectional survey of 4,983,807 admissions for acute stroke from 1994 to 2013 in the National Inpatient Sample compared stroke patients with depression and anxiety to stroke patients with no psychiatric comorbidities. The database was operationalized based on the inclusion/exclusion criteria approved by the Southern Illinois University School of Medicine Institutional Review Board. RESULTS: Patients with anxiety and depression were more likely to have an ischemic stroke (OR 1.64; 95% CI, 1.61 to 1.68) vs a non-ischemic stroke (OR 1.25; 95% CI, 1.23 to 1.27). Inpatient mortality was significantly less in both the depression and anxiety groups compared to the control group. CONCLUSIONS: Psychiatric disorders (anxiety and depression) may increase the risk of ischemic stroke; however, depressed and anxiety patients with ischemic stroke were less likely to die from stroke. Further well-designed studies are necessary to explore these findings.