Survey of prevalence and correlates of depressive symptoms, anxiety symptoms, stress symptoms and symptoms of Post-Traumatic Stress Disorder among stroke patients in a tertiary care hospital in Sri Lanka

Background: Neuropsychiatric symptoms, such as depression, anxiety, and PTSD, are common complications following a stroke, negatively impacting recovery and outcomes. Although post-stroke depression has been researched in Sri Lankan patients, there has been limited focus on anxiety and PTSD. This study aims to address this knowledge gap.
Aim: This research seeks to determine the prevalence of depression, anxiety, stress, and PTSD among post-stroke patients at Colombo North Teaching Hospital and Ragama Rehabilitation Hospital and to explore the interrelationships among these symptoms.
Method: A cross-sectional descriptive study was conducted with 285 participants who experienced either ischemic or hemorrhagic stroke within the past one month to two years. Neuropsychiatric symptoms were evaluated using the Depression Anxiety Stress Scale (DASS-21) and the Post-Traumatic Stress Symptom Scale – Self Report (PSS-SR).
Results: The study revealed a high prevalence of depression (53%), anxiety (52%), stress (58%), and PTSD (34%) among participants, significantly exceeding general population rates (p<0.001). Correlations were noted between these symptoms and various factors: depression was associated with the female gender (p=0.004), poor family support (p=0.002), and high disability (p=0.011); anxiety correlated with female gender (p=0.001), recent stroke onset (p=0.0002), and tobacco use disorder (p=0.01); stress was linked to female gender (p=0.001), lower education (p=0.034), lack of a partner (p=0.004), and tobacco use (p=0.009); PTSD correlated with poor family support (p=0.023), higher education (p=0.015), employment at stroke onset (p=0.004), hemorrhagic stroke (p=0.023), and severe disability (p=0.0003).
Conclusions: This study highlights a significant prevalence of non-cognitive neuropsychiatric symptoms in Sri Lankan post-stroke patients. Regular evaluation by medical professionals trained in liaison psychiatry is recommended to improve patient care and outcomes.