http://stroke.ahajournals.org/content/27/2/270
A 3-Year Longitudinal Study
Abstract
Background and Purpose This prospective study
examined the prevalence and longitudinal course of generalized anxiety
disorder (GAD) after stroke and its comorbidity with major depression
over time. The contributions of lesion characteristics, functional
impairment, and psychosocial factors to the development of GAD after
stroke were studied.
Methods In a population-based cohort of 80
patients with acute stroke, we assessed GAD and comorbid major
depression, functional ability, and social network at regular time
points over 3 years. Cerebral atrophy and brain lesion parameters were
determined from CT scans performed at the acute stage and after 3 years.
Results The prevalence of GAD after stroke
was 28% in the acute stage, and there was no significant decrease
through the 3 years of follow-up. At 1 year, only 23% of the patients
with early GAD (0 to 3 months) had recovered; those not recovered at
this follow-up had a high risk of a chronic development of the anxiety
disorder. Comorbidity with major depression was high and seemed to
impair the prognosis of depression. At the acute stage after stroke, GAD
plus depression was associated with left hemispheric lesion, whereas
anxiety alone was associated with right hemispheric lesion. Cerebral
atrophy was associated with both depression and anxiety disorder late
but not early after stroke. Dependence in activities of daily living and
reduced social network were associated with GAD at all follow-up
periods except at the acute stage.
Conclusions GAD after stroke is a common and
long-lasting affliction that interferes substantially with social life
and functional recovery. There is a differentiation of factors
implicated in its development based on the period of time since the
stroke event.
No comments:
Post a Comment