Background: Depression and anxiety after stroke are common conditions that are likely
to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric
disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke
anxiety (PSA) has not been sufficiently investigated.
Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow-
up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One
hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3,
and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder
7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First,
we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression
and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders
after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using
multivariate Cox regression analysis.
Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence
rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6
months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate
Cox regression analysis indicated independent positive associations between PSD risk and
higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63,
95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99)
Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of
the RBC indices, higher MCV, showed an independent positive association with PSD.