Cited by 180Stroke Rehabilitation and RecoveryCardiac Health and Mental HealthCancer survivorship and care

Frequency of anxiety after stroke: An updated systematic review and meta-analysis of observational studies

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Knapp, Peter, Dunn-Roberts, Alexander, Sahib, Nimah, Cook, Liz, Astin, Felicity, Kontou, Eirini, Thomas, Shirley A·2020·International Journal of Stroke

Abstract

Background: Anxiety is a common and distressing problem after stroke. Aims: To undertake an updated systematic review and meta-analysis of observational studies of anxiety after stroke and integrate the findings with those reported previously. Summary of review: Multiple databases were searched in May 2018 and 53 new studies were included following dual independent sifting and data extraction. These were combined with 44 previous studies to form a combined data set of 97 studies, comprising 22,262 participants. Studies using interview methods were of higher quality. Rates of anxiety by interview were 18.7% (95% confidence interval 12.5, 24.9%) and 24.2% (95% confidence interval 21.5, 26.9%) by rating scale. Rates of anxiety did not lower meaningfully up to 24 months after stroke. Eight different anxiety subtypes were also reported. Conclusions: This review confirms that anxiety occurs in around one in four patients (by rating scale) and one in five patients (by interview). More research on anxiety subtypes is needed for an informed understanding of its effects and the development of interventions.

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Research works printed but not linked: 29

  1. Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
  2. Bruggimann L, Annoni J, Staub F, et al. Chronic post-traumatic stress symptoms after non-severe stroke. Neurology 2006; 66: 513-16.
  3. Ibrahimagic OC, Sinanovic O and Smajlovic D. Anxiety in acute phase of ischemic stroke and myocardial infarction. Med Arh 2005; 59: 366-9.
  4. Langhorne P, Stott DJ, Robertson L, et al. Medical complications after stroke -multi-center study. Stroke 2000; 31: 1223-9.
  5. Li SB. Psychological mood and its related factors in patients with cerebral infarction. Chin J Clin Rehabil 2006; 10: 186-8.
  6. Masskulpan P, Riewthong K, Dajpratham P, et al. Anxiety and depressive symptoms after stroke in 9 rehabilitation centers. J Med Assoc Thai 2008; 91: 1595-602.
  7. Sembi S, Tarrier N, O'Neill P, et al. Does post-traumatic stress disorder occur after stroke: a preliminary study. Int J Geriatr Psychiatry 1998; 13: 315-22.
  8. Watanabe H, Koseki K, and Sudo M. A psychological study of stroke inpatients. Multi-variant analysis of anxiety. IRYO Jpn J Natl Med Serv 1984; 38: 1101-5.
  9. Zhao R. Evaluation on psychological status in patients with stroke. Chin J Clin Psychol 1999; 7: 230-1.
  10. Ajiboye PO, Abiodun OA, Tunde-Ayinmode MF, et al. Psychiatric morbidity in stroke patients attending a neurology clinic in Nigeria. African Health Sciences 2013; 13: 624-631.
  11. Beghi M, Cornaggia CM, Di Giacomo E, et al. Stroke and Psychiatric Disorders. Rivista di Psichiatria 2009; 44: 55-63.
  12. Bovim M. Factors in the early phase associated with anxiety, depression and pain three months after stroke. Results from a Norwegian multisite cohort-study. International Journal of Stroke 2016; 11 (Suppl 3), p235.
  13. Chinchaladze L, Lobjanidze N, Janelidze M, et al. Generalized post-stroke anxiety disorders: clinical and radiological correlation. International Journal of Psychiatry in Clinical Practice 2013; 17 (suppl 2): 17-18.
  14. Chun HY, Whiteley WN, Dennis MS, et al. Anxiety after stroke: the importance of subtyping. Stroke 2018; 49: 556-64.
  15. Delva M, Lytvynenko N and Delva I. Factors associated with post-stroke fatigue during the second half year after stroke. Georgian Medical News 2017; 11: 59-64.
  16. Garikimukku S, Stikrishna N, Mopineni V, et al. Prevalence of psychiatric morbidity in stroke patients: a hospital based study. Indian Journal of Psychiatry 2015; 57: S48-S49.
  17. Mellon L, Williams D, Brewer L, et al. Mood and cognitive impairment following stroke. A profile of Irish stroke survivors from the ASPIRE-S cohort. International Journal of Stroke 2013; 8 (Suppl 3): 28.
  18. Mumladze L, Lobjanidze N and Janelidze M. Autonomic panic disorders after stroke: clinical features and neuroimaging correlations. International Journal of Stroke 2016; 11 (Suppl 3): 91-92.
  19. Petrova MA, Savina MA, Kontsevoy VA, et al. Clinical characteristics of post-stroke anxiety disorders. Klininka Nervnykh I Psikhicheskikh Zabolevanii 2012; 9: 12-16.
  20. Solgajova A, Sollar T, Vorosova G, et al. Personality as significant predictor of post-stroke anxiety. Neuroendocrinology Letters 2017; 38: 290-264.
  21. Verma G, Sharma DK, Sushil CS, et al. A study of psychiatric illnesses in post stroke patients according to site and nature of lesion. Indian Journal of Psychiatry 2012; 54: S45-S46.
  22. Vuletic V, Lezaic Z and Morovic S. Post-stroke fatigue. Acta Clinica Croatica 2011; 50: 344.
  23. Vuletic V, Sapina L, Lozert M, et al. Anxiety and depressive symptoms in acute ischemic stroke. Acta Clinica Croatica, 2012; 51: 243-246.
  24. Wu S, Ma L, Sun Z, et al. Analysis of depression and anxiety in patients with post-stroke epilepsy. International Journal of Clinical and Experimental Medicine 2017; 10: 6994-6999.
  25. Zalihic A, Markotic V, Mabic M, et al. Differences in quality of life after stroke and myocardial infarction. Psychiatria Danubia 2010; 22: 241-248.
  26. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998; 59: 22-33.
  27. Spitzer RL, Kroenke K, Williams JBW, et al A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006; 166: 1092-1097.
  28. Wright F, Wu S, Chun H-Y, et al. Factors Associated with Post-stroke Anxiety: A Systematic Review and Meta-Analysis. Stroke Research and Treatment 2017; Article ID: 2124743.
  29. Azanmasso, 2017, Benin Hospital/cross- sectional/ NR/NR NR 54.3 years HADS (cut off NR) >6 months 67 22.4 (12.4, 32.4) Summary of evidence 24 Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers). 6-8 Limitations 25 Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias). 6-8 Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research. 6-8 FUNDING Funding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

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Authors
Knapp, P., Dunn-Roberts, A., Sahib, N., Cook, L., Astin, F., Kontou, E., & Thomas, S. A.
Affiliations
  • University of York (GB)
  • Hull York Medical School (GB)
  • University of Huddersfield (GB)
  • University of Nottingham (GB)
Corresponding author
Knapp, Peter
Venue
International Journal of Stroke
Published
2020-01-24
Volume
15
Issue
3
Pages
244-255
ISSN
  • 1747-4930 (ISSN-L)
  • 1747-4949
OpenAlex
W4214948227
Cited by
180
References
99
Citations by year
2026: 40 · 2025: 26 · 2024: 33 · 2023: 27 · 2022: 28 · 2021: 19 · 2020: 7
FWCI
2.49
Type
journal article
Language
en
Locations
  • International Journal of Stroke (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Repository@Nottingham (University of Nottingham) (acceptedVersion, other-oa)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
  • Huddersfield Research Portal (University of Huddersfield) (submittedVersion, other-oa)
Funders
National Institute for Health and Care Research (NIHR-INF-2005)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
anxiety, stroke, anxiety prevalence, anxiety subtypes

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