Exploring the prevalence and predictors of depression and anxiety in a cohort of transient ischaemic attack (TIA) or minor stroke survivors: an analysis of the International comparison of Systems of care and patient outcomes In minor Stroke and TIA (INSIST) study

Objective: Depression or anxiety affects over half of patients after moderate to severe stroke; however, their prevalence, incidence, and predictors after milder ischaemic events–transient ischaemic attack (TIA) or minor stroke–are underexplored. To explore the prevalence, incidence, severity, and predictors of depression or anxiety in patients post TIA or minor stroke. Method: Data from the INSIST cohort study of Australian TIA or minor stroke patients were analysed (patient characteristics, outcome measures). Prevalence and incidence were estimated. Multivariable logistic regression modelling identified predictors of either depression or anxiety. Results: Among 298 patients (58.7% TIA, 41.3% minor stroke), 16.1% suffered from depression or anxiety. At baseline, anxiety was more prevalent than depression (13.1 vs 7.4%; p = 0.02), while 4.5% were assessed as having both. The prevalence of depression or anxiety decreased at 3 months but increased at 12 months, particularly among younger patients (<65 years) and those experiencing fatigue. The total incidence of depression or anxiety among patients with milder ischaemic events was 9.4%, decreasing from baseline (5.9%) to 12 months (0.9%). Anxiety and depression strongly predicted each other at baseline and 12 months (OR: 24.7, p = 0.013; OR: 22.8, p < 0.0001). At 3 months, fatigue significantly impacted post-stroke depression (OR: 6.6, p < 0.0001). At 12 months, younger patients (<65 years) were 6.8 times more likely to have anxiety (p = 0.001). Conclusions: Depression or anxiety are common among patients with TIA or minor stroke, particularly among younger patients and those with concurrent fatigue. This highlights the importance of screening and monitoring of these conditions.