The high prevalence of anxiety disorders after stroke

This is so fucking easy to explain. You just need to think a little bit. Your doctor doesn't give you any stroke protocols and doesn't explain any way to get back to 100% recovery. Your doctor also doesn't give you any assurances that your next stroke can be prevented. With those two extreme stressors every stroke survivor should be as anxious as hell. To solve this you create stroke rehab protocols and prevention interventions that work. But that would mean our stroke medical professionals would actually have to do some difficult work instead of just sitting on their asses and telling us, 'All strokes are different, all stroke recoveries are different'.
http://www.ajgponline.org/article/S1064-7481%2815%2900189-X/abstract?rss=yes

Toby B. Cumming, PhD

,

Christian Blomstrand, PhD

,

Ingmar Skoog, PhD

,

Thomas Linden, PhD

Received: January 29, 2015; Received in revised form: June 10, 2015; Accepted: June 15, 2015; Published Online: June 26, 2015

Publication stage: In Press Accepted Manuscript

DOI: http://dx.doi.org/10.1016/j.jagp.2015.06.003

Article Info

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Abstract

Objectives

– Previous studies indicate that post-stroke anxiety is common and persistent. We aimed to determine whether point prevalence of anxiety after stroke is higher than in the population at large, and whether the profile of anxiety symptoms is different.

Design

– Case-control study.

Setting

– The study was conducted in Göteborg, Sweden, with stroke patients recruited from the Sahlgrenska University Hospital and a comparison group selected from local population health studies. Participants – We included 149 stroke survivors (assessed at 20 months post-stroke) and 745 participants from the general population matched for age and sex.

Measurements

A comprehensive psychiatric interview was conducted, with anxiety and depressive disorders diagnosed according to DSM-III-R criteria.

Results

– Those in the stroke group were significantly more likely than those in the comparison group to have generalized anxiety disorder (GAD) (27% versus 8%), phobic disorder (24% versus 8%) and obsessive-compulsive disorder (9% versus 2%). Multivariate regression indicated that being in the stroke group, female sex, and having depression were all significant independent associates of having an anxiety disorder. In terms of symptom profile, stroke survivors with GAD were significantly more likely to report vegetative disturbance than those in the comparison group with GAD but less likely to have observable muscle tension or reduced sleep.

Conclusions

– Point prevalence of anxiety disorders is markedly higher after stroke than in the general population, and this cannot be attributed to higher rates of co-morbid depression.