Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year

Abstract

Stroke is one of the most common diseases and has several potential consequences, such as psychological problems and pain. Return to work (RTW) after stroke in working-age individuals is incomplete. The present study aimed to investigate differences in self-perceived general health, pain, and depression between 1 and 5 years post-stroke related to RTW status. The study was nationwide, registry-based and the study population (n = 398) consisted of working-age people who had a stroke in 2011 and participated in 1-year and 5-year follow-up questionnaire surveys. Shift analyses with the Wilcoxon signed rank test and logistic regression were used. RTW within the first year post-stroke was associated with better self-perceived general health, less pain, and less depression both at 1 and 5 years post-stroke, compared with the no-RTW group. However, the RTW group had significant deterioration in general health and pain between 1 and 5 years, while the no-RTW group had no significant change. RTW was a significant predictor of lower odds of improvement in general health and pain between 1 and 5 years. This emphasizes the need for continued follow-up and support to ensure a balance between work and health for RTW individuals after stroke. Globally, stroke is the second largest cause of death and the second most common cause of disability 1. Although the total incidence of stroke is decreasing in most parts of the world, the number of disability adjusted life years is increasing 1 , as is the incidence of stroke in the working age population (20-64 years old) 2. Consequences of stroke, in addition to physical and cognitive impairment, include depression 3 and pain 4. The prevalence varies, but it has been estimated that approximately 1 of 3 suffers from depression 3 and up to half of the people have pain post-stroke 4. Ten years post-stroke, pain and psychological problems are two of the symptoms still experienced by a substantial proportion of people with stroke 5. Hypothetical recovery trajectories after stroke show a fast recovery during the first weeks and plateaus after approximately 6 months. After the initial 6 months the patterns are heterogeneous, with some people declining and some continuing to improve 6. In line with this, improvements in activities of daily living the first year poststroke has been reported, but between 1 and 3 years post-stroke there seems to be a small decline 7. Participants in another study reported less self-efficacy, less optimism and less proactive coping 2 years post-stroke compared with 2 months post-stroke 8. A decline in several self-reported functional aspects such as strength, activities of daily living, and mobility between 1 and 6 years post-stroke has also been reported 9. Absence from work due to sickness could have an effect on the individual's life situation as a whole. In addition to its impact on the financial situation, being on long-term sick leave is detrimental to psychological well-being and sleep 10 , and is even a risk factor for developing stroke 11. Working seems to...

Effects of Immersive Virtual Therapy as a Method Supporting Recovery of Depressive Symptoms in Post-Stroke Rehabilitation: Randomized Controlled Trial

“…However, PSD can effectively hinder the resumption of work, thereby locking the patients into their illness and reducing their chances of psychosocial and functional recovery. 46 For instance, pain and depression are important comorbidities. Both clinical and preclinical studies clearly indicate that pain can cause depression and that depression can worsen pain behaviours.…”