Background: Post-stroke mood disorders are common and associated with poorer functional outcomes and reduced quality of life. Anxiety affects 18–24% of stroke survivors, while depression affects 31–33%. Despite guideline recommendations, post-discharge screening remains inconsistent. We aimed to assess the prevalence of anxiety and depression 4–6 months post-stroke, examine demographic factors associated with response status, and evaluate feasibility outcomes of a post-stroke mood screening programme.
Methods: This prospective cohort study included patients aged ≥18 years discharged with ischaemic stroke, transient ischaemic attack, or intracerebral haemorrhage between October 2022 and February 2024 from a comprehensive stroke centre in NSW, Australia. Exclusion criteria were a) current/recent multidisciplinary rehabilitation, b) current post-discharge mental health services, c) residential aged care placement, d) end-of-life care, or e) residence outside the health district. Eligible patients were mailed validated mood screening tools. High-scoring patients meeting pre-defined criteria were referred to a rapid-access psychiatry clinic.
Results: Of 825 patients identified, 485 were eligible and 236 (49%) responded. Responders were older than non-responders (median 75 vs 71 years, p<0.01), with a trend towards fewer males (58% vs 66%, p=0.052). Among responders, 84 (35%) scored above thresholds for anxiety and/or depression. Of these, 18 (21%) were referred to psychiatry; 14 attended, and 10 (71%) received interventions, including medication initiation and/or psychology referral.
Conclusion: Post-stroke anxiety and depression were highly prevalent. This pilot screening programme was feasible, identified one in three responders with symptoms, and enabled targeted psychiatric intervention in most reviewed patients.