Article

This article examines practical approaches to increasing rates of
screening for depression and anxiety in hospital-based stroke services. METHOD:
The literature on depression and anxiety following stroke is briefly reviewed
together with evidence relating to screening. A small-scale trial of an
educational and support package to improve screening rates compared 30
consecutive admissions before and after the intervention. An extended commentary
on the outcome considered alternative approaches to improving screening. RESULTS:
The literature review confirmed that depression after stroke has multiple adverse
effects and that screening is not universally applied. There has been less
research into anxiety after stroke, but it is likely that anxiety screening is
also incomplete. The trial of the intervention to promote screening demonstrated
strong trends towards improvement for depression (23.3%; odds ratio 2.67; chi(2)
p = 0.067) and a trend for anxiety (16.7%; odds ratio 1.96; chi(2) p = 0.20).
CONCLUSIONS: Education and training about depression and anxiety screening and
access to screening materials improved rates of screening to a limited degree. An
extended commentary explored how screening rates might be further improved by
considering the intervention strategy, the staffing model, the training approach
and the screening methods themselves. Finally, consideration is given to
treatment approaches for mood disorders.

Langue : ANGLAIS