Investigation of psychological and sleep states in patients with Intracerebral hemorrhage and analysis of influencing Factors: A Single-Center Case-Control study

Abstract

Introduction: This study explores the prevalence of anxiety and depression at various time points during the rehabilitation of intracerebral hemorrhage (ICH) patients, ascertains their sleep quality, and analyzes influencing factors regarding psychological conditions, family and society.

Methods: Multiple questionnaires were employed to assess the disease and psychological status of ICH patients at different time points following onset. Assessments were conducted upon hospital admission, as well as at 1, 3, 6, and 12 months (s) after onset. Simultaneously, data regarding the rehabilitation support provided by caregivers or family members were collected. The prevalence and correlation of psychological disorders in patients during rehabilitation were analyzed. A comprehensive discussion was made on the factors influencing psychological disorders in ICH patients. Our study accounted for patient-specific, family, and psychological factors at different time points.

Results: 524 ICH patients were ultimately enrolled in this study. Results showed that the prevalence of moderate-to-severe anxiety and depression gradually declined over one year post-discharge, while the sleep quality fluctuated, peaking at 1 and 6 months. Multivariate analysis identified several risk factors, encompassing male gender, low muscle strength, lack of exercise, unemployment (OR < 1), hypertension, lower family income (OR > 1), prolonged daily caregiving hours (OR > 1), caregivers’ limited disease knowledge, and low caregiver enthusiasm (OR < 1). Psychological scores exhibited intercorrelations. For instance, anxiety and depression were strongly correlated at 1 month post-discharge (r = 0.730). Admission SSS (Somatic Symptom Scale) scores significantly predicted anxiety, while depression was linked to PSQI (Pittsburgh Sleep Quality Index), SSS, and Barthel Index scores. The sleep quality was influenced by HAMD (Hamilton Depression Scale) and Barthel scores. These findings highlighted that psychological issues in ICH patients, though prevalent, declined over time, affected by patient characteristics (physical function, socioeconomic status), caregiver dynamics, and multidimensional psychological interactions.

Conclusion: Following the onset of ICH, patients commonly exhibit varying degrees of anxiety, depression, and sleep quality. The prevalence of these conditions declines progressively throughout the rehabilitation period. Psychological and sleep-related outcomes are influenced by a combination of individual characteristics, familial circumstances, and multiple psychosocial factors, underscoring the need for comprehensive nursing care and multidimensional support.