Post-interventional anxiety and depression in patients undergoing endovascular therapy for acute ischemic stroke: A retrospective cohort study

doi:10.5498/wjp.v16.i8.119007

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 119007
Published online Aug 19, 2026. doi: 10.5498/wjp.v16.i8.119007

Post-interventional anxiety and depression in patients undergoing endovascular therapy for acute ischemic stroke: A retrospective cohort study

Jing-Li Wang, Jun-Jie Shao, Yu-Yi Xie, Yu-Hao Ding, Chao Yu

Chao Yu, Yu-Hao Ding, Yu-Yi Xie, Jun-Jie Shao, Jing-Li Wang, Stroke Center, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China

Author contributions: Yu C conceived and designed the study, supervised the research process, performed data analysis, and drafted and critically revised the manuscript; Ding YH and Xie YY contributed to data collection, patient follow-up, and acquisition of clinical and psychological assessment data; Shao JJ participated in statistical analysis, interpretation of the results, and manuscript revision; Wang JL contributed to study coordination, data verification, and critical revision of the manuscript. All authors have read and approved the final manuscript.

Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of Nantong University Affiliated Hospital, No. 2025-K315-01.

Informed consent statement: Due to the retrospective nature of the study, the Ethics Committee agrees to waive informed consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: There is no additional data available.

Corresponding author: Chao Yu, MMED, Stroke Center, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong 226001, Jiangsu Province, China. yuchao1990@protonmail.com

Received: March 3, 2026
Revised: March 22, 2026
Accepted: April 13, 2026
Published online: August 19, 2026
Processing time: 137 Days and 11.4 Hours

Abstract

BACKGROUND

Endovascular therapy (EVT) has revolutionized the management of acute ischemic stroke (AIS) caused by large-vessel occlusion, significantly improving functional outcomes. However, the psychological sequelae following EVT, particularly anxiety and depression, remain insufficiently characterized. A clearer understanding of the prevalence and predictors of post-interventional anxiety and depression is essential for delivering comprehensive stroke care.

AIM

To evaluate the prevalence, severity, and risk factors associated with post-interventional anxiety and depression in patients undergoing EVT for AIS.

METHODS

This retrospective cohort study included 228 patients who underwent EVT for AIS at our comprehensive stroke center between January 2022 and December 2025. Anxiety and depression were assessed at 3 months post-intervention using the Hospital Anxiety and Depression Scale. Demographic, clinical, procedural, and functional outcome data were collected. Multivariate logistic regression analyses were performed to identify independent predictors of anxiety and depression.

RESULTS

At 3 months post-EVT, the prevalence of clinically significant anxiety and depression was 31.6% (n = 72) and 38.2% (n = 87), respectively. Comorbid anxiety and depression were observed in 22.4% (n = 51) of patients. Independent predictors of post-interventional depression included female sex [odds ratio (OR) = 2.34, 95% confidence interval (CI): 1.28-4.27, P = 0.006], pre-stroke depression history (OR = 3.89, 95%CI: 1.76-8.61, P = 0.001), higher baseline National Institutes of Health Stroke Scale score (OR = 1.12, 95%CI: 1.04-1.21, P = 0.003), unsuccessful recanalization (OR = 2.67, 95%CI: 1.31-5.44, P = 0.007), and poor functional outcome at 90 days (OR = 3.21, 95%CI: 1.68-6.13, P < 0.001). Independent predictors of post-interventional anxiety included younger age (OR = 0.97, 95%CI: 0.94-0.99, P = 0.018), female sex (OR = 2.18, 95%CI: 1.19-3.99, P = 0.012), and longer hospital stay (OR = 1.08, 95%CI: 1.02-1.15, P = 0.009).

CONCLUSION

Post-interventional anxiety and depression are highly prevalent among patients with AIS following EVT. Routine psychological screening and early intervention strategies should be integrated into post-EVT care pathways, particularly for patients at increased risk.

Keywords: Acute ischemic stroke; Endovascular therapy; Mechanical thrombectomy; Post-stroke depression; Post-stroke anxiety; Psychological outcomes

Core Tip: This study emphasizes the high burden of psychological complications following endovascular therapy for acute ischemic stroke. By identifying distinct clinical and demographic risk factors, our findings underscore the critical need for integrating proactive, risk-stratified mental health screening and targeted psychological interventions into comprehensive post-stroke care pathways.