Feasibility of SMS-based screening for mood disturbances after minor stroke: strengths and limitations

Stroke frequently causes invisible sequelae such as depression, anxiety, fatigue, and cognitive dysfunction that remain underdiagnosed. Simple and accessible screening tools are needed to support their early detection. This study assessed the feasibility and validity of an SMS-based questionnaire in identifying mood disturbances, fatigue and cognitive complaints before follow-up visits around 3-6 weeks post stroke. 100 minor stroke patients responded to SMS questions on mood, fatigue, and cognition starting from 15 days before their follow-up. Responses were compared with validated scales: Hospital Anxiety and Depression (HAD), Center of Epidemiological Studies Depression (CES-D), Multidimensional Fatigue Inventory (MFI), and Montreal Cognitive Assessment (MoCA). Associations were examined through group comparisons and correlation analyses.Two-thirds of patients responded to at least one SMS, with lower stroke severity predicting higher adherence. Among responders, 37.8% showed probable depression and 34.07% exhibited probable anxiety based on mood scales, and 29.3% reported depression and 29.4% reported anxiety based on SMS responses. SMS-identified depression and anxiety were strongly associated with higher CES-D and HAD scores (p < 0.001). SMS fatigue intensity correlated moderately with fatigue and mood scores. SMS-identified cognitive complaints were associated with higher MFI Mental fatigue scores (p = 0.008) but not with MoCA scores. SMS-based screening appears feasible and useful for detecting mood disturbances after minor stroke but is less suitable for cognitive screening. Larger, more diverse studies with refined measures are required to validate SMS as a scalable post-stroke follow-up tool.