Anxiety and depression in incident stroke survivors and their carers in rural Tanzania: A case-control follow-up study over five years

Authors

Matthew P. Jones, North Tyneside General Hospital,UK
Suzanne C. Howitt, North Tyneside General Hospital, UK
Ahmed Jusabani, Aga Khan UniversityFollow
William K. Gray, North Tyneside General Hospital, UK
Eric Aris, Muhimbili University Hospital, Tanzania
Ferdinand Mugusi, Muhimbili University Hospital, Tanzania
Mark Swai, Kilimanjaro Christian Medical Centre, Tanzania
Richard W. Walker, North Tyneside General Hospital, UK

Document Type

Article

Department

Imaging and Diagnostic Radiology (East Africa)

Abstract

Aims

To quantify the extent and nature of anxiety and depression in a representative cohort of stroke survivors and their carers in rural Tanzania.

Design

A cross-sectional design was used and stroke cases were followed up at 6–60 months post-stroke. Levels of anxiety and depression in stroke survivors, their carers (for physically dependent stroke survivors) and age- and sex-matched controls were assessed using the hospital anxiety and depression (HAD) scale. Other data collected included age, sex, time elapsed since stroke, quality of life, cognitive function, level of disability and socioeconomic status.

Results

Levels of depression seen in our cohort of stroke survivors (53.0%) are high compared to data from the developed and developing world. Anxiety levels (21.6%) are similar to published data. Stroke survivors (n = 58, full data set n = 51) and carers (n = 27) were significantly more anxious than controls (n = 58), whereas levels of depression were similar across all three groups. High stroke survivor HAD scores correlated with lower scores in physical health, psychological health and environment sections of the WHOQOL-Bref. Increased carer anxiety and depression were associated with reduced informant-reported levels of cognitive function in stroke survivors.

Conclusions

To our knowledge this is the first long term study of incident stroke cases in sub-Saharan Africa which has investigated the psychological health of stroke survivors and their carers. Our study highlights the growing need to develop community rehabilitation services in the developing world, which address both physical and psychological morbidity.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Neurology, Psychiatry and Brain Research

Recommended Citation

Jones, M. P., Howitt, S. C., Jusabani, A., Gray, W. K., Aris, E., Mugusi, F., ... & Walker, R. W. (2012). Anxiety and depression in incident stroke survivors and their carers in rural Tanzania: A case-control follow-up study over five years. Neurology, Psychiatry and Brain Research, 18(3), 122-128.