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Outcomes following acute hospital care for stroke or hip fracture: how useful is an assessment of anxiety or depression for older people?
Author(s) -
Bond John,
Gregson Barbara,
Smith Monica,
Rousseau Nikki,
Lecouturier Jan,
Rodgers Helen
Publication year - 1998
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/(sici)1099-1166(199809)13:9<601::aid-gps827>3.0.co;2-b
Subject(s) - depression (economics) , anxiety , hip fracture , stroke (engine) , medicine , physical therapy , psychiatry , gerontology , physical medicine and rehabilitation , psychology , osteoporosis , mechanical engineering , engineering , economics , macroeconomics
Objective . To investigate the association between severe life events and mental health outcomes following acute hospital care for older patients with acute stroke or fractured neck of femur. Design . Prospective longitudinal survey of stroke and hip fracture patients admitted to hospital from admission to 6‐month follow‐up. Setting . Six district general hospitals, three in the North and three in the South of England. Participants . 642 patients admitted to hospital with an acute stroke (268) or hip fracture (374) resident in a private household at 6 months follow‐up. Main outcome measures . Hospital Anxiety and Depression Scale, cognitive items of the Survey Psychiatric Assessment Scale, Clackmannan Disability Scale, Severe Life Events Inventory, Wenger Social Support Network Typology. Results . 47% of 6‐month survivors of stroke or hip fracture resident in private households had a possible psychiatric illness: dementia (13%), anxiety or depression (41%). 57% had severe or very severe disability and 48% experienced additional life events (17% two or more) after hospital admission. Severe disability was strongly associated with a higher prevalence of anxiety ( p <0·0005) or depression ( p <0·0001). Social contact was associated with a lower prevalence of anxiety ( p <0·01) or depression ( p <0·0001) and social support network type was strongly associated with depression ( p <0·001) but not anxiety ( p =0·096). Number of severe life events was associated with anxiety ( p <0·001) but not depression ( p =0·058). Conclusion . Disability is probably a more robust outcome measure than assessments of mental health for older people in uncontrolled studies. © 1998 John Wiley & Sons, Ltd.