Am J Psychiatry 1995; 152:1174-1179
Copyright © 1995 by American Psychiatric Association
Clinical correlates of early-onset and late-onset poststroke generalized anxiety
CS Castillo, SK Schultz and RG Robinson
Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City 52242-1057, USA.
OBJECTIVE: The authors' goal was to determine if generalized anxiety
diagnosed while a patient was hospitalized for stroke (early onset) had the
same clinical correlates as anxiety beginning 3 months or more after the
stroke (late onset). METHOD: Patients with acute stroke (N = 142) were
examined while they were in the hospital and 3, 6, 12, and 24 months later
for the presence of anxiety symptoms. Patients underwent a structured
psychiatric interview as well as assessment of cognitive, physical, and
social function at each visit. Patients with early-onset and late-onset
poststroke generalized anxiety were identified and compared to patients
without poststroke generalized anxiety. RESULTS: The frequency of
early-onset poststroke generalized anxiety was 27% and that of late-onset
poststroke generalized anxiety was 23%. Three- quarters of the anxious
patients had comorbid major or minor depression. Patients who developed
early-onset or late-onset poststroke generalized anxiety were no more
socially, cognitively, or physically impaired than patients who did not
develop anxiety. Early-onset but not late-onset anxiety was associated with
a previous history of psychiatric disorder. The median duration of
late-onset anxiety was 3.0 months, and that of early-onset anxiety was 1.5
months. The presence of anxiety was significantly associated with
depression; onset of depression and onset of anxiety occurred at
approximately the same time. CONCLUSIONS: These findings suggest that
although early-onset and late-onset poststroke generalized anxiety are
phenomenologically similar, they may be the result of different
pathophysiological mechanisms.
