Post-stroke psyche may limit return to work
NEW YORK (Reuters Health) - Physical ability may not be the only factor determining whether a person returns to work after suffering a stroke. Psychiatric factors, such as anxiety and depression, also appear to impact return-to-work, suggest findings from a study conducted in New Zealand.
Because getting back to work after stroke is strongly associated with a greater quality of life, targeting post-stroke interventions to enable people to return to work seem important, the study team notes in the medical journal Stroke.
Dr. Nick Glozier, of The George Institute of International Health in Sydney, Australia, and colleagues assessed factors that impact the odds of returning to work in 1429 patients with first-ever strokes.
A total of 279 patients who were 55 years old on average reported being in paid employment at the time of their stroke. After 6 months, 210 of these were still alive and about half had returned to work.
As expected, stroke severity was independently associated with a lower likelihood of returning to work, the researchers report. Eighty-six percent of the patients still hospitalized at the 1-month assessment were unable to return to work. By contrast, 94 percent who were living at home within 1 month had returned to work within 6 months.
But the researchers also found the presence psychiatric problems, such as anxiety, insomnia, and depression were independently associated with not returning to work. Among the 155 patients assessed 1 month after their stroke, psychiatric issues were detected in 64 percent of those not working compared with 43 percent of those back on the job.
The findings of this study, Glozier and colleagues say, indicate that potentially treatable post-stroke factors, such as anxiety and depression, are important predictors of patient outcome. Early identification and treatment of these factors could assist in earlier return to work, they conclude.
SOURCE: Stroke, May 2008
