Clinical correlates of early-onset and late-onset poststroke generalized anxiety

Am J Psychiatry. 1995 Aug;152(8):1174-9. doi: 10.1176/ajp.152.8.1174.

Abstract

Objective: The authors' goal was to determine if generalized anxiety diagnosed while a patient was hospitalized for stroke (early onset) had the same clinical correlates as anxiety beginning 3 months or more after the stroke (late onset).

Method: Patients with acute stroke (N = 142) were examined while they were in the hospital and 3, 6, 12, and 24 months later for the presence of anxiety symptoms. Patients underwent a structured psychiatric interview as well as assessment of cognitive, physical, and social function at each visit. Patients with early-onset and late-onset poststroke generalized anxiety were identified and compared to patients without poststroke generalized anxiety.

Results: The frequency of early-onset poststroke generalized anxiety was 27% and that of late-onset poststroke generalized anxiety was 23%. Three-quarters of the anxious patients had comorbid major or minor depression. Patients who developed early-onset or late-onset poststroke generalized anxiety were no more socially, cognitively, or physically impaired than patients who did not develop anxiety. Early-onset but not late-onset anxiety was associated with a previous history of psychiatric disorder. The median duration of late-onset anxiety was 3.0 months, and that of early-onset anxiety was 1.5 months. The presence of anxiety was significantly associated with depression; onset of depression and onset of anxiety occurred at approximately the same time.

Conclusions: These findings suggest that although early-onset and late-onset poststroke generalized anxiety are phenomenologically similar, they may be the result of different pathophysiological mechanisms.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / etiology
  • Cerebrovascular Disorders / complications*
  • Cerebrovascular Disorders / epidemiology
  • Comorbidity
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Prevalence
  • Psychiatric Status Rating Scales