Content » Vol 50, Issue 9

Review article

Anxiety after stroke: A systematic review and meta-analysis

Lena Rafsten, Anna Danielsson, Katharina S. Sunnerhagen
Clinical Neuroscience and Rehabilitation Medicine, Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 46 Gothenburg, Sweden. E-mail:
DOI: 10.2340/16501977-2384


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%), (I2 = 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 (I2 = 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.

Lay Abstract

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.

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