Self report questionnaire assessment of anxiety and depression amongst stroke patients in rehabilitation settings

Hanlon, Blair (2010) Self report questionnaire assessment of anxiety and depression amongst stroke patients in rehabilitation settings. D Clin Psy thesis, University of Glasgow.

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Background and purpose: Depression and anxiety are common stroke sequelae and are detrimental
to outcomes if not detected and addressed. Some self-report measures of anxiety and depression
have been criticised for lack of specificity and face validity of item structure [Hospital Anxiety and
Depression Scale - HADS] or may not be fully validated for a stroke population [Geriatric Depression
Scale Short Form - GDS-SF]. A recently developed anxiety measure may be useful for this population
[Geriatric Anxiety Inventory - GAI]. The purpose of the study is to assess the clinical utility of these
measures for screening mood disorders in people over 45 years old undergoing stroke rehabilitation.
Methods: The HADS, GAI and GDS-SF were assessed against DSM-IV “gold standard” diagnoses from
the Mini International Neuropsychiatric Interview [MINI]. A sample of patients in rehabilitation
following stroke (n=34) was used. The age range was 46-92 (mean 73.12 years; SD=12.37). 21
participants were female and 13 were male (61.8% and 38.2% respectively). The study sample had
relatively intact cognitive function as assessed by referring clinicians and relatively high
communicative ability with Frenchay Aphasia Screening Test [FAST] scores in the range 18 to 30
(mean 26.38; SD=2.94).
Results: All measures were able to distinguish those with index disorders from those without. HADSA
displayed sensitivity 91%, specificity 70% at a cut-off of 8/21. HADS-D displayed sensitivity 82%,
specificity 83% at a cut-off of 8/21. GAI displayed sensitivity 91%, specificity 65% at a cut-off of 8/20.
GDS-SF displayed sensitivity 63%, specificity 87% at a cut-off of 8/15.
Conclusions: All conclusions are tentative as this is a small scale preliminary study. The HADS
performed best in screening for anxiety and depression, and is suitable for use with a cognitively
intact stroke population. The GAI also performed well and is suitable for use with this population.
The GDS-SF had poor sensitivity and so does not appear suitable for this population.

Item Type: Thesis (D Clin Psy)
Qualification Level: Doctoral
Keywords: depression, anxiety, stroke, rehabilitation, screening, HADS, GAI, GDS-SF
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Colleges/Schools: College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing
Supervisor's Name: Jonathan, Professor Evans
Date of Award: 2010
Depositing User: Mr B Hanlon
Unique ID: glathesis:2010-2281
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 20 Nov 2010
Last Modified: 10 Dec 2012 13:53

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