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Frequency of anxiety after stroke: An updated systematic review and meta-analysis of observational studies
Open accessAbstract
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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“Individuals suffering from acquired brain injury (ABI), such as a traumatic brain injury (TBI) or a stroke are at increased risk of developing anxiety or depressive symptoms (Knapp et al., 2020; Kreutzer et al., 2001).”
From Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases. (2023) · cites this paper as Knapp et al., 2020
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Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
PRISMA-P Group, Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., & Stewart, L. A. (2015) · Systematic Reviews · doi:10.1186/2046-4053-4-1 · Cited by 26,223
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407
The assessment of anxiety states by rating
HAMILTON, M. (1959) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1959.tb00467.x · Cited by 11,455
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
Hu, R. J. (2003) · Elsevier eBooks · doi:10.1016/b0-12-226870-9/01070-4 · Cited by 9,168
(1988) · NFER-Nelson eBooks · Cited by 5,560
A Rating Instrument For Anxiety Disorders
Zung, W. W. K. (1971) · Psychosomatics · doi:10.1016/s0033-3182(71)71479-0 · Cited by 4,578
A personality scale of manifest anxiety
Taylor, J. A. (1953) · The Journal of Abnormal and Social Psychology · doi:10.1037/h0056264 · Cited by 3,131
The Neuropsychiatric Inventory
Cummings, J. L. (1997) · Neurology · doi:10.1212/wnl.48.5_suppl_6.10s · Cited by 2,055
Research works printed but not linked: 29
- Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
- Ibrahimagic OC, 2005, Med Arh, 59, 366
- Li SB, 2006, Chin J Clin Rehabil, 10, 186
- Masskulpan P, 2008, J Med Assoc Thai, 91, 1595
- Watanabe H, 1984, IRYO Jpn J Natl Med Serv, 38, 1101
- Zhao R, 1999, Chin J Clin Psychol, 7, 230
- Ajiboye PO, 2013, Afr Health Sci, 13, 624
- Azanmasso H, 2017, Cerebrovasc Dis, 43, 100
- Beghi M, 2009, Rivista di Psichiatria, 44, 55
- Bovim M, 2016, Int J Stroke, 11, 235
- Chanchaem R, 2013, Cerebrovasc Dis, 36, 40
- Chinchaladze L, 2013, Int J Psychiat Clin Pract, 17, 17
- Crowley D, 2018, Aging Mental Health, 10, 1
- 10.1161/STROKEAHA.117.020078 · DOI · Paper page
- Delva M, 2017, Georgian Med News, 11, 59
- Garikimukku S, 2015, Ind J Psychiat, 57, S48
- Ibrahimagic OC, 2013, Cerebrovasc Dis, 35, 701
- Mulroy M, 2012, Stroke, 43, A89
- Petrova EA, 2012, Klininka Nervnykh I Psikhicheskikh Zabolevanii, 9, 12
- Ponchel A, 2016, Stroke Res Treat, 2410921
- Solgajova A, 2017, Neuroendocrinol Lett, 38
- Verma G, 2012, Ind J Psychiat, 54, S45
- Vuletic V, 2011, Acta Clinica Croatica, 50, 344
- Vuletić V, 2012, Acta Clinica Croatica, 51, 243
- Wu S, 2017, Int J Clin Exp Med, 10, 6994
- Zalihic A, 2010, Psychiatria Danubia, 22, 241
- American Psychiatric Association, 2016, Structured Clinical Interview for DSM-5 (SCID-5)
- Sheehan DV, 1998, J Clin Psychiatry, 59, 22
- Wright F, 2017, Stroke Res Treat, 2124743
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Wan, X.-J., Chau, J., Mou, H.-Y., & Liu, X. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104001 · Cited by 65
Ignacio, K. H. D., Muir, R. T., Diestro, J. D. B., Singh, N., Yu, M. H. L. L., Omari, O. E., Abdalrahman, R., Barker-Collo, S. L., Hackett, M. L., Dukelow, S. P., et al. (2024) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2024.107732 · Cited by 49
Long-term psychological outcomes following stroke: the OX-CHRONIC study
Kusec, A., Milosevich, E. T., Williams, O. A., Chiu, E. G., Watson, P., Carrick, C., Drozdowska, B. A., Dillon, A., Jennings, T., Anderson, B., et al. (2023) · BMC Neurology · doi:10.1186/s12883-023-03463-5 · Cited by 47
“Emotional distress after stroke is also common, with post-stroke depression and anxiety estimated to affect 31.0% and 24.2% of stroke survivors respectively [8, 9].”
BackgroundResultInfluentialSelf-citationZhang, S.-H., Wang, Y., Zhang, C.-X., Zhang, C., Xiao, P., Li, Q.-F., Liang, W.-R., Pan, X., & Zhou, M. (2021) · Chinese Journal of Integrative Medicine · doi:10.1007/s11655-021-3338-1 · Cited by 45
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BackgroundO’Callaghan, G., Fahy, M. P., Murphy, P., Langhorne, P., Galvin, R., & Horgan, F. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08473-6 · Cited by 48
“Post-stroke depression impacts 30 to 40% of people with stroke [39]; while post-stroke anxiety is seen in 20–25% of people with stroke [40].”
BackgroundPrevalence, Trajectory, and Factors Associated With Patient-Reported Nonmotor Outcomes After Stroke
Özkan, H., Ambler, G., Esmail, T., Banerjee, G., Simister, R. J., & Werring, D. J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.57447 · Cited by 43
Depression prevalence in cardiovascular disease: global systematic review and meta-analysis
Rafiei, S., Raoofi, S., Baghaei, A., Masoumi, M., Doustmehraban, M., Nejatifar, Z., Sanaei, M., Bagheribayati, F., Shahrebabak, E. S. V., Shayestehbonyan, M., et al. (2023) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2022-003884 · Cited by 35
Bojanić, I., Sund, E. R., Sletvold, H., & Bjerkeset, O. A. (2021) · BMC Psychology · doi:10.1186/s40359-021-00636-0 · Cited by 36
“The findings that CVDs are significantly associated with symptoms of depression and anxiety are consistent with literature showing that these psychological symptoms are common after CVDs [16, 20, 75].”
BackgroundResultInterventions for improving psychosocial well-being after stroke: A systematic review
van Nimwegen, D., Hjelle, E. G., Bragstad, L. K., Kirkevold, M., Sveen, U., Hafsteinsdøttir, T. B., Schoonhoven, L., Visser‐Meily, J. M. A., & Ginkel, J. M. D. M. (2023) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2023.104492 · Cited by 45
Mystery of gamma wave stimulation in brain disorders
Deng, Q., Wu, C., Parker, E., Zhu, J., Liu, T. C., Duan, R., & Yang, L. (2024) · Molecular Neurodegeneration · doi:10.1186/s13024-024-00785-x · Cited by 36
The longitudinal course of anxiety, depression and apathy through two years after stroke
Sagen, U., Finset, A., Moum, T., Vik, T. G., & Dammen, T. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111016 · Cited by 32
Rauwenhoff, J. C. C., Bol, Y., Peeters, F., van den Hout, A. J. H. C., Geusgens, C. A. V., & van Heugten, C. M. (2023) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2053169 · Cited by 31
“Individuals suffering from acquired brain injury (ABI), such as a traumatic brain injury (TBI) or a stroke are at increased risk of developing anxiety or depressive symptoms (Knapp et al., 2020; Kreutzer et al., 2001).”
BackgroundMahadevan, S. K., Chan, M. F., Moghadas, M., Shetty, M., Burke, D. T., Al‐Rasadi, K., & Al‐Adawi, S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10163655 · Cited by 30
“[81] have reported the results of a systematic review and meta-analysis of 97 observational studies (n = 22,262) of anxiety after stroke.”
BackgroundEvaluation & Treatment of Psychological Effects of Stroke
Devereux, N., & Berns, A. M. (2023) · Delaware Journal of Public Health · doi:10.32481/djph.2023.08.011 · Cited by 47
Guillaumier, A., Spratt, N. J., Pollack, M. R. P., Baker, A., Magin, P. J., Turner, A., Oldmeadow, C. J., Collins, C. E., Callister, R., Levi, C. R., et al. (2022) · PLoS Medicine · doi:10.1371/journal.pmed.1003966 · Cited by 31
“Rates of anxiety (12%) and depression (12%) at baseline among our relatively ‘well’ stroke survivor sample were much lower than depression (31%) [43] and anxiety (24%) [44] rates typically reported in stroke survivors.”
BackgroundSkajaa, N., Adelborg, K., Horváth-Puhó, E., Rothman, K., Henderson, V., Thygesen, L., & Sørensen, H. (2022) · Stroke · doi:10.1161/strokeaha.121.037740 · Cited by 28
Ryan, B. J., Clunne, S. M., Baker, C. J., Shiggins, C., Rose, M. L., & Kneebone, I. I. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2021.1925752 · Cited by 25
Liu, Y.-E., Lv, J., Sun, F., Liang, J., Zhang, Y., Chen, J., & Jiang, W. (2023) · Brain and Behavior · doi:10.1002/brb3.3260 · Cited by 25
Kowalska, K., Droś, J., Mazurek, M., Pasińska, P., Gorzkowska, A., & Klimkowicz-Mrowiec, A. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9072232 · Cited by 22
“The prevalence of anxiety after the stroke in our study was similar to what was previously observed, both in the acute phase of stroke [29] as well as over the 12 months post-stroke.”
ResultZhu, H., Guo, Y., Huang, A., Shen, H., Chen, Y., Song, J., Guan, A., Wu, L., Wang, H., & Deng, B. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.845678 · Cited by 25
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Spectrum of neuropsychiatric symptoms in chronic post-stroke aphasia
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Ruthmann, F., Lo, J. W., Mendyk-Bordet, A.-M., Allart, E., Köhler, S., Klimkowicz-Mrowiec, A., Staals, J., Sachdev, P. S., Bordet, R., & Dondaine, T. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.10.099 · Cited by 23
Post-stroke Anxiety Analysis via Machine Learning Methods
Wang, J., Zhao, D., Lin, M., Huang, X., & Shang, X. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.657937 · Cited by 27
“Specifically, Knapp et al. (2020) collect and analyze 53 studies and report 25.5% of stroke patients developed PSA within 1 month of stroke, 23.6% in 1 and 5 months, and 21.5% in 6 months to 1 year.”
BackgroundInfluentialIdentifying emotional contributors to participation post-stroke
Lee, Y., Nicholas, M. L., & Connor, L. T. (2021) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2021.2008597 · Cited by 22
Smorti, M., Ponti, L., Soffio, F., Argirò, A., Perfetto, F., Zampieri, M., Mazzoni, C., Tomberli, A., Allinovi, M., Mario, C. D., et al. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1066224 · Cited by 22
“Several works have shown an increased prevalence of depression and anxiety in adults with different types of cardiovascular diseases (CVD) compared to people free from these conditions (Ormel et al., 2007; Knapp et al., 2020).”
BackgroundBright, F. A. S., Ibell‐Roberts, C., Featherstone, K., Signal, N., Wilson, B., Collier, A., & Fu, V. W. Y. (2024) · Health Expectations · doi:10.1111/hex.14016 · Cited by 23
“68 We contend that it should not be seen as inevitable that people have significant reductions in friendships, 11 and quality of life, 69 or that 20% of people experience anxiety after stroke 70 and 30% experience depression 71 — rates doubled if someone has aphasia.”
BackgroundMood and Cognitive Trajectories Over the First Year after Mild Ischemic Stroke
Ebaid, D., Bird, L., McCambridge, L. J. E., Werden, E., Bradshaw, J., Cumming, T. B., Tang, E. Y. H., & Brodtmann, A. G. (2022) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2022.106323 · Cited by 20
The prevalence of anxiety symptoms/disorders in cancer patients: a meta-analysis
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“001 Hospital presentation ≥1¶ 12 (0) 43 (2) <0.”
BackgroundMethodWelten, J. J. E., Cox, V. C., Kruithof, W. J., Visser‐Meily, J. M. A., Post, M. W. M., Heugten, C. M. V., & Schepers, V. P. M. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2051564 · Cited by 17
“…depression that we reported for the individual members of the dyad (patients or partners) is in accordance with literature (Hackett & Pickles, 2014; Knapp et al., 2020; Loh et al., 2017; Rafsten et al., 2018), except for the prevalence for clinically relevant depressive symptoms in the partner…”
ResultJiang, Y., Liu, Q., Zhao, Y., Wang, C., & Sun, M. (2022) · Molecular Neurobiology · doi:10.1007/s12035-022-03174-x · Cited by 18
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“In recent years, increasing evidence has demonstrated that PSF is associated with cognitive impairment, affective disorders, disability, and biological factors [7,8].”
BackgroundDifferential Association of Serum BDNF With Poststroke Depression and Poststroke Anxiety
Han, Z., Wang, Y., Qi, L., Wang, J., Wong, J. W., Chen, J., Luo, X., & Wang, Q. M. (2020) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2020.04.011 · Cited by 16
Atigossou, O. L. G., Ouédraogo, F., Honado, A. S., Alagnide, E., Kpadonou, T. G., & Batcho, C. S. (2022) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2083703 · Cited by 16
Predictors and prognoses of new onset post-stroke anxiety at one year in black Africans
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“A recently updated systematic review of 53 studies of PSA in the global literature(34) also found that the pooled prevalence of anxiety increased steadily in the first year of stroke, and did not show much decline in the first 24 months.”
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“Prior studies reported that the duration of the stroke was mentioned as a risk factor for PSD with a high prevalence in the first year [33].”
BackgroundWang, S., Meng, H., Zhang, Y., Mao, J., Zhang, C., Qian, C., Ma, Y., & Guo, L. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.10.006 · Cited by 18
Kliem, E., Gjestad, E., Ryum, T., Olsen, A., Thommessen, B., Indredavik, B., Bieliauskas, L., Due-Tønnessen, P., Fladby, T., & Grambaitė, R. (2021) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617721000187 · Cited by 15
“Inconsistent results might be due to the time of assessment, as anxiety is less prevalent 6–12 months post-stroke compared to the first 6 months (Knapp et al., 2020).”
ResultKarlsson, J., Hammarström, E., Fogelkvist, M., & Lundqvist, L. (2024) · PLoS ONE · doi:10.1371/journal.pone.0306754 · Cited by 14
Merriman, N. A., Gillan, D., Pender, N. P., Williams, D. J., Horgan, F., Sexton, E., Johnston, M., Bennett, K., Donnelly, N.-A., Wren, M., et al. (2020) · Psychology and Health · doi:10.1080/08870446.2020.1820009 · Cited by 14
“Emotional well-being/adjustment can be affected post-stroke, with anxiety affecting 20% to 25% of stroke survivors (Knapp et al., 2020).”
BackgroundVolk, P., Manesh, M. R., Warren, M. E., Besko, K., de Andrade, E. G., Wicki‐Stordeur, L. E., & Swayne, L. A. (2023) · Journal of Neurochemistry · doi:10.1111/jnc.16016 · Cited by 14
Domain-specific cognitive impairments, mood and quality of life 6 months after stroke
Milosevich, E. T., Kusec, A., Pendlebury, S. T., & Demeyere, N. (2024) · Disability and Rehabilitation · doi:10.1080/09638288.2024.2340121 · Cited by 13
Wheeler, M., Williams, O. A., Johns, L., Chiu, E. G., Slavkova, E. D., & Demeyere, N. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2042329 · Cited by 14
“Post-stroke depression and anxiety are common psychological consequences of stroke, with prevalence estimated to be 15–40%, and 18–24% respectively (Knapp et al., 2020; Mitchell et al., 2017; Wu et al., 2019).”
BackgroundParkinson, B., Lawrence, M., McElhinney, E., & Booth, J. (2022) · Journal of Holistic Nursing · doi:10.1177/08980101221135723 · Cited by 13
“The prevalence of post-stroke anxiety is estimated at 18.7% (95% CI, 12.5, 24.9) when assessed using clinical interview and 24.2% (95% CI, 21.5, 26.9) when assessed using a rating scale (Knapp et al., 2020).”
MethodInfluentialWan, X., Chau, J. P. C., Wu, Y., Limei, X., & Gong, W. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-062531 · Cited by 12
Psychosocial well-being after stroke in Aotearoa New Zealand: a qualitative metasynthesis
Bright, F. A. S., Ibell‐Roberts, C., & Wilson, B. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2212178 · Cited by 11
“The psychological impacts such as depression and anxiety affect many, with approximately one third of people experiencing depression [1] and one quarter experiencing anxiety [2,3].”
BackgroundLawrence, M., Davis, B., Amicis, L. D., Booth, J., Dickson, S., Dougall, N. J., Grealy, M., Jani, B., Maxwell, M., Parkinson, B., et al. (2023) · Healthcare · doi:10.3390/healthcare11030355 · Cited by 12
Post-stroke Anxiety Among Patients in Jordan: A Multihospital Study
Ayasrah, S. M., Ahmad, M. M., Basheti, I. A., Abu‐Snieneh, H. M., & Al‐Hamdan, Z. M. (2021) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/08919887211060015 · Cited by 12
“An informed understanding of anxiety prevalence and its risk factors among patients with stroke is crucial for early detection, planning, and implementing interventions aimed at decreasing anxiety and enhancing patients’ outcomes.(19,29)”
BackgroundResultPrevalence of depression and its associated factors among stroke survivors in Saudi Arabia
Abuadas, F. H. A., Ayasrah, S. M., Ahmad, M. M., Abu‐Snieneh, H. M., Obiedallah, H. F., & Basheti, I. A. (2022) · Nursing Open · doi:10.1002/nop2.1417 · Cited by 11
“Even though PSD is common, there is still confusion about predisposing risk factors and the best preventative and treatment measures (Knapp et al., 2020; Kutlubaev & Hackett, 2014).”
BackgroundResultZeng, H.-J., Zhao, W.-J., Zeng, J., Wang, R., Luo, H., Wen, C.-M., Liu, Y.-B., Li, D., & Zeng, X. (2024) · International Journal of Stroke · doi:10.1177/17474930241306916 · Cited by 11
“Anxiety in ischemic stroke deserves clinical attention, not only because it affects more than 20% of the patients, 4 but also because ischemic stroke accounts for 80–85% of all stroke cases.”
Evaluating the GAD-2 to screen for post-stroke anxiety on an acute stroke unit
McCrory, M., Murphy, D. F., Morris, R. C., & Noad, R. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2030366 · Cited by 10
“When calculating PPV and NPA using a 19% base rate for anxiety, as identified by Knapp et al (2020), the cut off score of 0/1 produced an unacceptably low accuracy for positively identifying anxiety, i.e., only 1 in 3 patients who scored above the cut off would be experiencing the condition.”
BackgroundMethodInfluentialFitzgerald, S., Gracey, F., & Broomfield, N. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.2002439 · Cited by 9
Liu, W., Liu, X., Wang, J., Peng, S., Li, J., Pei, M., Qiu, Z., & Zhang, P. (2023) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2023.107368 · Cited by 12
An Integrated Perspective for Understanding the Psychosocial Impact of Acute Cardiovascular Events
Jackson, A. C., Rogerson, M. C., & Murphy, B. M. (2023) · Heart and Mind · doi:10.4103/hm.hm-d-23-00029 · Cited by 9
Atkinson, T., Brown, E., Jones, G. L., Sage, K., & Wang, X. (2023) · Healthcare · doi:10.3390/healthcare11030399 · Cited by 9
“Psychological interventions designed to reduce anxiety and distress in stroke survivors are limited [1].”
BackgroundZhu, Q., Chen, L., Xu, Q., Xu, J., Zhang, L., & Wang, J. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.04.016 · Cited by 9
Griffiths, M., Kontou, E., & Ford, C. E. L. (2023) · British Journal of Hospital Medicine · doi:10.12968/hmed.2023.0289 · Cited by 8
Self-citationSoler, R. S., Maldonado-Manzano, E., Rodrigo-Gil, J., Font‐Mayolas, S., Pérez, M. E. G., Terceño, M., Silva, Y., Serena, J. L., & Grau, A. (2024) · Brain Sciences · doi:10.3390/brainsci14060521 · Cited by 8
“With regard to anxiety, our results are similar to those described in a systematic review of 97 studies, including 22,262 stroke survivors, with a prevalence of 23.6% in the first five months and 21.5% from 6 to 12 months [28].”
ResultInfluentialRichards, L. G., Ifejika, N. L., Stein, J., Bahouth, M. N., Saylor, M. A., Barrett, A. M., Chen, P., Deutsch, A. F., Dusenbury, W., Ellis, C., et al. (2026) · Stroke · doi:10.1161/str.0000000000000536 · Cited by 11
Systematic Review of Existing Stroke Guidelines: Case for a Change
Wijeratne, T., Sales, C., Wijeratne, C., Karimi, L., & Jakovljević, M. (2022) · BioMed Research International · doi:10.1155/2022/5514793 · Cited by 8
“%) by rating scales [43, 99] with likely increased risk of further stroke and downward spiral from the psycho-neuroimmunological PNI point of view.”
Humphrey, S., Pike, K. E., Long, B., Ma, H., Bourke, R., Wright, B. J., & Wong, D. K. (2024) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617724000535 · Cited by 8
“…such as anxiety, depression, and fatigue are also common after stroke, with almost half of all stroke survivors experiencing fatigue, a quarter anxiety, and a third depression (Burton et al., 2013; Hackett & Pickles, 2014; Knapp et al., 2020; Liu et al., 2023; Paciaroni & Acciarresi, 2019).”
InfluentialBroomfield, N. M., West, R. M., Barber, M., Quinn, T. J., Gillespie, D. C., Walters, J., & House, A. O. (2022) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2022-329042 · Cited by 8
Phan, A., Askim, T., Lydersen, S., Indredavik, B., & Wethal, T. (2023) · Journal of Rehabilitation Medicine · doi:10.2340/jrm.v55.12309 · Cited by 8
“Furthermore, past estimates vary largely due to differences in time of assessment, study setting, heterogeneity of study population, and different caseness thresholds for rating scales, as well as assessment methods (2, 3, 30).”
BackgroundResultPoststroke Anxiety: The Other Poststroke Mood Disorder
MacKenzie, J. J., & Gomez, V. M. (2024) · Stroke · doi:10.1161/strokeaha.124.048771 · Cited by 8
Hobden, G., Tang, E. Y. H., & Demeyere, N. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-11551-6 · Cited by 7
Eticha, B. L., Yalew, E. S., Merawie, D. M., Chanie, S. T., Demissie, K. A., & Eticha, B. L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1545807 · Cited by 7
“This inconsistency could also be associated with socioeconomic factors, the study population, and methodological differences (56).”
InfluentialPsychiatric symptoms in stroke patients: Clinical features of depression and anxiety
Li, J.-M., Long, S.-S., Lu, T.-X., Jiang, Y.-C., Zhang, X.-W., & Ren, Y.-Q. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i6.103888 · Cited by 7
Huang, D. Y., Fan, Y., Zhang, J., Wang, Q., Ding, M. L., Hou, R., Yu, K., Xiao, X., Wu, Y., & Wu, J. (2024) · Experimental Neurology · doi:10.1016/j.expneurol.2024.114801 · Cited by 7
van der Velde, M. Y., Aerden, L. A. M., van Oort, A., Bodde, K., Mishre, R. R., & Oosterveer, D. M. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2021.2023583 · Cited by 7
“A systematic review found an overall prevalence of 18.7% of anxiety disorders in stroke patients when diagnosed by interview and 24.2% by rating scale, in periods ranging from one month after stroke to ten years after stroke (Knapp et al., 2020).”
BackgroundInfluentialPoststroke Depression and Anxiety: A Comprehensive Topical Review
Terrill, A. L., Gomez, V. M., Kumar, M., & MacKenzie, J. J. (2026) · Stroke · doi:10.1161/strokeaha.125.051664 · Cited by 8
Liang, C., Veth, A. V. L., Li, Q., Zheng, D., & Hackett, M. L. (2021) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2021.1922802 · Cited by 6
Fitzgerald, S., Gracey, F., Trigg, E., & Broomfield, N. M. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2052326 · Cited by 6
“Research has found individuals with emotionalism have an increased likelihood of developing psychiatric outcomes such as depression (Tang et al., 2004), anxiety (Knapp et al., 2020) and anger (Kneebone & Lincoln, 2012).”
BackgroundHealth risk factors in Australian Stroke Survivors: A latent class analysis
Clancy, B., Bonevski, B., English, C., Callister, R., Baker, A., Collins, C. E., Pollack, M. R. P., Magin, P. J., Turner, A., Faulkner, J., et al. (2023) · Health Promotion Journal of Australia · doi:10.1002/hpja.706 · Cited by 5
Lawrence, M., Davis, B., Clark, N. E., Booth, J., Donald, G., Dougall, N. J., Fenocchi, L., Grealy, M., Jamieson, M., Jani, B., et al. (2025) · Mindfulness · doi:10.1007/s12671-025-02595-8 · Cited by 6
“disorders can occur after stroke (Devereux & Berns 2023) with depression (25% 1–5 years; Hackett & Pickles, 2014) and anxiety (19–24%; Knapp et al., 2020) being common.”
Self-citationKliem, E., Labberton, A. S., Barra, M., Olsen, A., Thommessen, B., Thomas, O. M. T., Gjestad, E., Indredavik, B., & Grambaitė, R. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.944586 · Cited by 7
“First, in our sample, approximately 20% of patients reported HADSA and -D scores above cut-off, which is a somewhat lower prevalence than usually found during the first months poststroke where around 36% of patients experience depression 2–6 months post-stroke (52) and around 24% report anxiety 1–5 months post-stroke…”
BackgroundFactors Associated With Anxiety After Hemorrhagic Stroke
Olivera, A., Ecker, S., Lord, A. S., Gurin, L. J., Ishida, K., Melmed, K. R., Torres, J., Zhang, C., Frontera, J. A., & Lewis, A. K. (2023) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.20220218 · Cited by 5
Long-term psychological outcomes following stroke: The OX-CHRONIC studyPreprint
Kusec, A., Milosevich, E. T., Williams, O. A., Chiu, E. G., Watson, P., Carrick, C., Drozdowska, B. A., Dillon, A., Jennings, T., Anderson, B., et al. (2023) · medRxiv · doi:10.1101/2023.03.27.23287789 · Cited by 5
Self-citationSathananthan, N., Morris, E. M. J., das Nair, R., Gillanders, D. T., Wright, B. J., & Wong, D. K. (2025) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2025.2476074 · Cited by 4
“Acquired brain injuries (ABI) frequently cause cognitive and emotional difficulties that persist beyond the acute recovery period (Knapp et al., 2020; Rabino-witz & Levin, 2014; Stolwyk et al., 2021).”
Li, H., Zhou, L., Liu, G., Wang, L., Zhao, Q., Shaohong, X., & Cai, E. (2025) · Journal of Integrative Neuroscience · doi:10.31083/jin27142 · Cited by 6
Towards a Latin American neuropsychiatry: challenges and opportunities
Ramírez‐Bermúdez, J., Castro‐Suárez, S., D'Alessio, L., Lew, J. H., Oliveira, L. M., Yassuda, M. S., Santamaría‐García, H. A., Slachevsky, A., Tamayo-Agudelo, W., Torales, J., et al. (2025) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2025.101322 · Cited by 5
“For post-stroke anxiety, Knapp et al. 28 reported meta-analytic estimates of 18.7% (95% CI 12.5–24.9) for interview-measure-estimated anxiety, and 24.2% (95% CI 21.5–26.9) for rating scale estimated anxiety.”
InfluentialRehabilitation in Animal Models of Stroke
Khan, M. (2023) · Physical Therapy Research · doi:10.1298/ptr.r0022 · Cited by 4
Li, R., Chen, S., Xie, X. S., Xia, S., Wang, W., Jiang, T., Chen, F., Tan, M., & Tao, J. (2025) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2025.110460 · Cited by 4
Kletsenko, L., Klevaka, L., Vyshar, Y., & Levkov, A. A. (2022) · Physical rehabilitation and recreational health technologies · doi:10.15391/prrht.2022-7(4).26 · Cited by 4
Metacognitive beliefs, mood symptoms, and fatigue four years after stroke: An explorative study
Pedersen, S. G., Anke, A., Friborg, O., Ørbo, M. C., Løkholm, M. T., Kirkevold, M., Heiberg, G. A., & Halvorsen, M. B. (2024) · PLoS ONE · doi:10.1371/journal.pone.0305896 · Cited by 4
Emotions and behavior after stroke
Markus, H. S. (2020) · International Journal of Stroke · doi:10.1177/1747493020913772 · Cited by 4
Trapero‐Asenjo, S., Fernández‐Guinea, S., Guillot, A., Pecos‐Martín, D., & Núñez-Nagy, S. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316723 · Cited by 3
Investigating the shared genetic architecture between anxiety and stroke
Zhang, Y., Jiang, Y., Fan, H., Yuan, R., Jianhui, C. A. I., Zhong, B., Qin, Q., Zhang, Y., Zhang, Y., & Cheng, S. (2024) · Behavioural Brain Research · doi:10.1016/j.bbr.2024.115400 · Cited by 3
Hancock, S., Thayabaranathan, T., Stolwyk, R. J., Cameron, J., Immink, M. A., Hillier, S., Kilkenny, M. F., Brodtmann, A. G., Carey, L. M., Olaiya, M. T., et al. (2025) · Mindfulness · doi:10.1007/s12671-025-02579-8 · Cited by 3
Li, Y., & Hu, S. (2025) · Clinical Nursing Research · doi:10.1177/10547738251354998 · Cited by 2
“Approximately one-third of stroke survivors are reported to suffer from post-stroke depression, while 20% experience anxiety symptoms following a stroke (Knapp et al., 2020).”
InfluentialAn evaluation of the validity of an aphasia friendly mood and anxiety measure for stroke patients
Murphy, D. F., Hourston, J., Freeman, E., Hawker, N., & Morris-Haynes, R. (2024) · Aphasiology · doi:10.1080/02687038.2024.2361512 · Cited by 3
Martinsen, R., Kitzmüller, G., Mangset, M., Kvigne, K. J., Evju, A. S., Bronken, B. A., Bragstad, L. K., Hjelle, E. G., Sveen, U., & Kirkevold, M. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06857-8 · Cited by 3
Link between post-stroke psychopathology and scope-of-action awareness
Stahl, B., Becker, K., Kocyigit, K., Denzler, P., & Röder, P. (2024) · Therapeutic Advances in Neurological Disorders · doi:10.1177/17562864241282633 · Cited by 2
Feely, D., Slattery, B. W., Walsh, T., Galvin, T., Donlon, K., Hanlon, M. L. D., Gormley, D., Brown, G.-M., Quinn, S., Robinson, S. M., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286220 · Cited by 2
“In line with estimated prevalence rates for anxiety after stroke [2], 33.”
InfluentialMao, Y.-C., Li, H.-H., Tao, S., Zhang, W., Zhang, L., Geng, D., Ren, N., & Gao, L. (2024) · Journal of Neuroscience Nursing · doi:10.1097/jnn.0000000000000798 · Cited by 3
Barker-Collo, S., Krishnamurthi, R., Nair, B., Ranta, A., Douwes, J., & Feigin, V. (2024) · Brain Impairment · doi:10.1071/ib24025
Rate of Post-Stroke Depression and Associated Factors in Saudi Single Tertiary Medical Center
Aljuhani, T., Subaie, S. A., Al-Mutairi, A., Altheyab, A., Alsahali, A., Al-Hamdan, A., Alqahtani, F., Olayan, L. H., & Senitan, M. (2025) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s542551 · Cited by 2
Metadata
- 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
- Publisher
- SAGE Publications
- 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
- Update notices
- correction (2021-08-04)
- Open access
- 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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