Self-reported mood disorders - a population level indicator of anxiety or depression following stroke

Monash research provides evidence that a single question on self-reported anxiety or depression has value as a population level indicator of anxiety or depression following stroke.

Mood disorders, such as anxiety or depression, affect 1 in 2 survivors within one-year after stroke, impacting their ongoing recovery and quality of life. Unfortunately, survivors of stroke are rarely routinely screened, or assessed, for mood disorders. When survivors of stroke are included in the Australian Stroke Clinical Registry, they are invited to complete a survey on their quality of life between 90-180 days after hospital admission.

"We wanted to assess the validity of self-reported anxiety or depression obtained from a single question against a more comprehensive questionnaire validated to detect these conditions in stroke. We provide evidence that a single question on self-reported anxiety or depression has value as a population level indicator of anxiety or depression following stroke", said lead researcher Dr Tharshanah Thayabaranathan.

"Less is more, whereby one question is just as acceptable as asking 14 questions to detect a mood disorder that potentially requires immediate attention. Survivors of stroke often suffer from multiple physical and emotional comorbidities (e.g. high blood pressure, diabetes, stress, fatigue, anxiety or depression). A simple screening method to identify individuals with anxiety or depression after stroke, while still maintaining robustness will permit the ability to immediately refer people for medical attention who might need additional support or assessments", she said.

Furthermore, the inclusion of a broader range of patient characteristics that have not been previously collected in the Australian Stroke Clinical Registry has provided evidence to Dr Thayabaranathan and her team, that these measures could help explain why some people experience poor quality of life outcomes.

"These additional measures on fatigue, cognitive ability, communication problems etc will be added into the follow-up survey for the Australian Stroke Clinical Registry to provide essential information back to clinicians".

"We can reduce response burden by minimising the number of questions that we ask survivors of stroke as an outcome of this research. Moreover, greater knowledge of the factors that contribute to anxiety or depression after stroke may help us to identify vulnerable people who need more support",

"It is important to be able to reliably identify all of those at risk of a serious but treatable disorder. To the best of our knowledge, this is the first study to correlate the psychometric properties of an established single question from the EQ-5D-3L with a more detailed questionnaire that has been validated for detecting anxiety and depression after stroke (Hospital Anxiety and Depression scale: 14 items)", said Dr Thayabaranathan.


Tharshanah Thayabaranathan, Nadine E Andrew, Rene Stolwyk, Natasha A Lannin, Dominique A Cadilhac. Comparing the EQ-5D-3L anxiety or depression domain to the Hospital Anxiety and Depression Scale to identify anxiety or depression after stroke. Topics in Stroke Rehabilitation 2021 Mar 17;1-10. doi: 10.1080/10749357.2021.1895494. Online ahead of print.