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Abstract
Poststroke aphasia hinders patients’ emotional processing and social adaptation. This study estimated the risks of depression and related symptoms in patients developing or not developing aphasia after various types of stroke. Using data from the US Collaborative Network within the TriNetX Diamond Network, we conducted a retrospective cohort study of adults experiencing their first stroke between 2013 and 2022. Diagnoses were confirmed using corresponding International Classification of Diseases, Tenth Revision, Clinical Modification codes. Patients were stratified by poststroke aphasia status and stroke type, with propensity score matching performed to control for confounders. The primary outcome was depression within one year post-stroke; secondary outcomes included anxiety, fatigue, agitation, emotional impact, and insomnia. Each matched group comprised 12,333 patients. The risk of depression was significantly higher in patients with poststroke aphasia (hazard ratio: 1.728; 95% CI 1.464–2.038; p < 0.001), especially those with post-hemorrhagic-stroke aphasia (hazard ratio: 2.321; 95% CI 1.814–2.970; p < 0.001). Patients with poststroke aphasia also had higher risks of fatigue, agitation, and emotional impact. Anxiety and insomnia risks were higher in those with post-hemorrhagic-stroke aphasia. Poststroke aphasia, particularly post-hemorrhagic-stroke aphasia, may increase the risks of depression and associated symptoms, indicating the need for comprehensive psychiatric assessments.
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1 Shin Kong Wu Ho-Su Memorial Hospital, Department of General Medicine, Taipei, Taiwan (GRID:grid.415755.7) (ISNI:0000 0004 0573 0483)
2 Shin Kong Wu Ho-Su Memorial Hospital, Department of Psychiatry, Taipei, Taiwan (GRID:grid.415755.7) (ISNI:0000 0004 0573 0483); Fu Jen University, School of Medicine, College of Medicine, Taipei, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922); National Yang-Ming Chiao-Tung University, Institute of Brain Science and Brain Research Center, School of Medicine, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017)