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Anxiety disorders after stroke: results from the Perth Community Stroke Study
P W Burvill1, G A Johnson, K D Jamrozik
1Department of Psychiatry and Behavioural Science, University of Western Australia, Perth.
Summary
Post-stroke anxiety disorders are common, especially in women. A non-hierarchic diagnostic approach reveals higher prevalence rates, with significant recovery or mortality observed at 12 months.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- Investigates anxiety disorder prevalence in stroke survivors from the Perth Community Stroke Study.
- Follows 294 patients surviving to 4 months post-stroke, with a 12-month follow-up.
Purpose of the Study:
- To determine the prevalence of anxiety disorders in stroke survivors.
- To compare diagnostic approaches (hierarchic vs. non-hierarchic) for anxiety disorders.
- To examine outcomes of post-stroke anxiety disorders at 12 months.
Main Methods:
- Employs both DSM hierarchic and non-hierarchic diagnostic methods for anxiety disorders.
- Analyzes data from 294 stroke survivors and community controls.
- Conducts a 12-month follow-up on patients with agoraphobia.
Main Results:
- Non-hierarchic diagnosis revealed higher anxiety disorder prevalence: 12% in men, 28% in women (vs. 5% men, 19% women hierarchic).
- Prevalence adjusted for pre-stroke anxiety was 9% in men, 20% in women.
- Agoraphobia was the most common anxiety disorder post-stroke.
Conclusions:
- A significant proportion of stroke survivors with anxiety disorders had pre-existing depression or anxiety.
- At 12 months, 51% of agoraphobia patients recovered; the rest either died or had persistent symptoms.
- Comorbid depression with anxiety disorders was associated with higher mortality.