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Anxiety after stroke: A systematic review and meta-analysis
Open accessAbstract
Anxiety is common during the first year after you have been diagnosed with stroke, with one in three experiencing it.Today anxiety after stroke gets significantly less attention compared to other psychological problems after stroke and one has reported dissatisfaction with the provision of psychological services after stroke.Since anxiety significantly influences quality of life, it is prevalent, and could be a predictor for depression.In this review, we have looked at the prevalence of anxiety at different times after stroke.We found that 29.3% of the patients had some form of anxiety disorders during the first year after stroke.The highest frequency, 36.7%, was 0-2 weeks after stroke onset.We suggest that clinicians should be more aware of anxiety that further routine screening post stroke may be worth considering providing appropriate interventions.Objective: To update the evidence surrounding the presence of anxiety after stroke.Data sources: A search was conducted in EMBASE, MEDLINE, PsycINFO, Cochrane Library, AMED and CINAHL in May 2015 and repeated in April 2017.Study selection: Clinical diagnosis of stroke and assessed for anxiety symptoms on a rating scale in the first year after stroke.Data extraction: One reviewer screened and identified studies against the inclusion criteria.A second reviewer conducted a random check of approximately 10% of titles and abstracts.Two authors independently performed the final full-text review.Data synthesis: Overall pooled prevalence of anxiety disorders was 29.3% ((95% confidence interval 24.8-33.8%),(I 2 = 97%, p < 0.00001)) during the first year.Frequency 0-2 weeks post-stroke was 36.7%, 2 weeks to 3 months 24.1%, and 3-12 months 23.8%.There was a statistically high heterogeneity in this estimate (I 2 = 97%, p < 0.00001).Conclusion: Anxiety is common during the first year post-stroke.Since anxiety significantly influences quality of life and is a predictor for depression, it may be worth considering further routine screening post-stroke.
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“Although treating these symptoms remains a challenge, evidence suggests that Acceptance and Commitment Therapy (ACT) can be an effective treatment for ABI-related anxiety and depressive symptoms (10–13).”
From Trial-based economic evaluation of the BrainACT study: acceptance and commitment therapy for anxiety and/or depressive symptoms after acquired brain injury. (2025) · cites this paper as [11]
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Cited by
Sorted by citations
Knapp, P., Dunn-Roberts, A., Sahib, N., Cook, L., Astin, F., Kontou, E., & Thomas, S. A. (2020) · International Journal of Stroke · doi:10.1177/1747493019896958 · Cited by 180
Lip, G. Y. H., Lane, D. A., Lenarczyk, R., Boriani, G., Doehner, W., Benjamin, L. A., Fisher, M., Lowe, D., Sacco, R. L., Schnabel, R. B., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehac245 · Cited by 165
Almhdawi, K. A., Alazrai, A., Kanaan, S. F., Shyyab, A. A., Oteir, A. O., Mansour, Z. M., & Jaber, H. (2020) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2020.1760893 · Cited by 87
“(Burton et al., 2013; Leppävuori et al., 2003; Lincoln et al., 2013; Ojagbemi et al., 2017; Rafsten et al., 2018; Schöttke & Giabbiconi, 2015).”
BackgroundResultInfluentialAhrens, J., Shao, R., Blackport, D., Macaluso, S., Viana, R., Teasell, R. W., & Mehta, S. (2022) · Topics in Stroke Rehabilitation · doi:10.1080/10749357.2022.2049505 · Cited by 65
“After suffering a stroke, patients commonly experience anxiety not only in the acute phase, but after months and years.(9) A systematic review in 2012 demonstrated that at least 20% of stroke patients experience anxiety.”
BackgroundSadlonova, M., Wasser, K., Nagel, J., Weber-Krüger, M., Gröschel, S., Uphaus, T., Liman, J., Hamann, G. F., Kermer, P., Gröschel, K., et al. (2021) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110353 · Cited by 64
Metadata
- Authors
- Rafsten, L., Danielsson, A., & Sunnerhagen, K.
- Affiliations
- Sahlgrenska University Hospital (SE)
- University of Gothenburg (SE)
- Corresponding author
- Rafsten, L
- Venue
- Journal of Rehabilitation Medicine
- Published
- 2018
- Volume
- 50
- Issue
- 9
- Pages
- 769-778
- ISSN
- 1650-1977 (ISSN-L)
- OpenAlex
- W2891418975
- Cited by
- 257
- References
- 58
- Citations by year
- 2026: 17 · 2025: 38 · 2024: 53 · 2023: 36 · 2022: 40 · 2021: 36 · 2020: 24 · 2019: 9 · 2018: 2
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Rehabilitation Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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, post-stroke anxiety, prevalence, anxiety disorders, depression, quality of life, psychological screening
- MeSH terms
- Aged, Anxiety, Humans, Middle Aged, Quality of Life, Stroke
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