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Generalized anxiety disorder after stroke

C S Castillo1, S E Starkstein, J P Fedoroff

  • 1Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City.

The Journal of Nervous and Mental Disease
|February 1, 1993
PubMed
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Anxiety in stroke patients is linked to brain injury location, not background or impairment severity. Anxiety alone correlates with right hemisphere lesions, while anxiety with depression links to left cortical damage.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Neurology

Background:

  • Anxiety disorders are common in stroke survivors.
  • The relationship between anxiety, depression, and brain lesion location in stroke patients requires further investigation.
  • Understanding these links can inform targeted interventions.

Purpose of the Study:

  • To investigate the prevalence of generalized anxiety disorder (GAD) symptoms in stroke admissions.
  • To explore the association between anxiety, depression, and lesion laterality in stroke patients.
  • To determine if background characteristics or impairment severity influence anxiety in stroke survivors.

Main Methods:

  • Examined 309 stroke unit admissions for anxiety symptoms using DSM-III-R criteria.
  • Classified patients into no anxiety, worry (not GAD), and GAD groups.

Related Experiment Videos

  • Assessed for major or minor depression and correlated anxiety/depression with lesion location (left/right hemisphere, anterior/posterior).

    • Main Results:

    • GAD and worry symptoms were present in 40.8% of stroke admissions.
    • Anxiety and depression co-occurred with left cortical lesions.
    • Anxiety alone was associated with right hemisphere lesions; specific locations (anterior/posterior) correlated with worry vs. GAD.
    • No significant differences in background, psychiatric history, social support, or physical impairment severity were found between anxiety groups.

    Conclusions:

    • Anxiety disorder in stroke patients is influenced by the location of brain injury, independent of depression.
    • Right hemisphere lesions are linked to anxiety alone, with specific locations correlating to worry or GAD.
    • Findings suggest a neuroanatomical basis for anxiety in stroke, distinct from demographic or clinical factors.