General Practitioners’ Views on Mental Health Following Stroke: Findings from a Cross-Sectional Study

Abstract Background Post-stroke mood changes currently affect a significant proportion of stroke survivors and are seldom recognised or treated in clinical practice. As general practitioners (GPs) typically know their patients well and see them regularly, they may be well-positioned to identify these mood changes. Methods A survey was distributed both postally and electronically to GPs currently practicing in Ireland assessing their beliefs around post-stroke mood changes, and confidence identifying and managing these conditions. Preferred treatment strategies and perceived barriers associated with identifying and managing these conditions were also explored. Quantitative data was analysed using descriptive and inferential statistics. A free-text section capturing any additional comments regarding GPs addressing post-stroke mood changes underwent reflexive thematic content analysis. Results Of 292 respondents, 85% agreed that currently post-stroke mood changes are underdiagnosed, and nearly two-thirds of GPs viewed themselves as the healthcare professionals most responsible for identifying and managing these mood changes. Despite this perceived responsibility, confidence in their ability to address these conditions were low, with only about one in four GPs expressing that they were at least very confident in their ability to both diagnose and manage post-stroke depression (27%), anxiety (26%), apathy (15%), and fatigue (15%). Similarly, the proportion of GPs that often or always screened for these conditions were low with post-stroke depression (45%), and anxiety (34%) being screened for more often than apathy (17%), and fatigue (23%). Conclusion This survey highlights that GPs often fail to diagnosis post-stroke mood changes in stroke survivors, presenting a crucial opportunity for earlier recognition. Enhanced support and resources are needed to help GPs effectively diagnose and manage symptoms such as low mood, fatigue and apathy. These findings can guide targeted resource allocation to overcome barriers in providing mental healthcare to stroke survivors.