Depression, anxiety and health-related quality of life after integrated psychological care in acute stroke: a prospective cohort

Abstract

Mood and anxiety symptoms are frequent after stroke and negatively impact recovery. We assessed the feasibility and early patient-reported outcomes of an integrated, brief psychological intervention delivered during acute/subacute stroke care at the IMSP Institute of Emergency Medicine. In a prospective servicedevelopment cohort (April–August 2025), consecutive adults admitted with ischemic or hemorrhagic stroke received up to six structured sessions focused on psychoeducation, coping skills, problem-solving, and support. Standardized measures were collected at baseline and after the intervention: EQ-5D profile and VAS, CANSAS, GAD-7, HAM-A, HAM-D, an PHQ-9, MMSE was recorded at entry where appropriate. Demographic and clinical characteristics (age, sex, education, social status, stroke subtype, comorbidities, and vitals) were extracted routinely. One hundred twenty-one patients were enrolled, most in the sixth and seventh decades of life; hypertension and cardiometabolic comorbidities were common. Follow-up data available after the intervention indicated consistent, clinically meaningful improvements across patient-reported outcomes: higher EQ-5D VAS scores and more favorable EQ-5D profiles, with reductions in anxiety and depressive symptom severity on GAD-7, HAM-A, HAM-D, and PHQ-9. Reported unmet needs on CANSAS decreased in domains related to information, psychological distress, and daily activities. No intervention-related adverse events were documented. These findings suggest that brief, structured psychological care is feasible in an emergency hospital setting and may enhance early recovery and well-being after stroke.