A Retrospective Study to Identify Novel Factors Associated with Post-stroke Anxiety

Jennifer E. Sanner Beauchamp, Tahani Casameni Montiel, Chunyan Cai, Sudha Tallavajhula, Evelyn Hinojosa, Munachi N. Okpala, Farhaan S. Vahidy, Sean I. Savitz, Anjail Z. Sharrief

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background and Purpose: Post-stroke anxiety (PSA) is common and disabling. PSA should be considered as an important outcome in stroke. However, there is a lack of understanding of factors that may be linked to PSA. The purpose of this study was to determine the frequency of PSA and sociodemographic and clinical factors associated with PSA in a cohort of racially and ethnically diverse stroke patients. Methods: We conducted a retrospective study of ischemic and hemorrhagic stroke patients seen in a stroke outpatient clinic from August 1, 2017 to June 30, 2018. Patients were eligible if a Generalized Anxiety Disorder 7-Item (GAD-7) instrument was available. GAD-7 scores greater than or equal to 10 indicated the presence of moderate to severe PSA. Multivariable logistic regression was used to identify independent sociodemographic and clinical factors associated with PSA. Results: Records from 289 stroke patients with a GAD-7 instrument were analyzed. PSA was common (21%; GAD-7 ≥ 10). Fifty-seven percent of females had a GAD-7 greater than or equal to 10 compared to 41% of females who had a GAD-7 less than 10 (P = .03). Multivariable analysis found that self-reported nonmarried status (odds ratio, 3.27; 95% confidence interval, 1.44-7.44), excessive fatigue (odds ratio, 4.46; 95% confidence interval, 1.87-10.63), and depression (odds ratio, 1.24; 95% confidence interval, 1.16-1.33) were independently associated with PSA. Conclusions: PSA may occur more frequently in those who report non-married, excessive fatigue, or depression. Trials of PSA interventions should consider the potential impact of social support, depression, and comorbid conditions contributing to post-stroke fatigue, including sleep apnea.

Original languageEnglish (US)
Article number104582
Pages (from-to)104582
JournalJournal of Stroke and Cerebrovascular Diseases
Volume29
Issue number2
DOIs
StatePublished - Feb 2020

Keywords

  • Anxiety
  • ischemic attack
  • neuropsychiatry
  • stroke
  • transient attack
  • Prognosis
  • Fatigue/epidemiology
  • Humans
  • Middle Aged
  • Brain Ischemia/diagnosis
  • Male
  • Mental Health
  • Depression/epidemiology
  • Adult
  • Female
  • Retrospective Studies
  • Social Isolation
  • Ischemic Attack, Transient/diagnosis
  • Intracranial Hemorrhages/complications
  • Stroke/diagnosis
  • Risk Assessment
  • Comorbidity
  • Risk Factors
  • Single Person/psychology
  • Texas/epidemiology
  • Anxiety/diagnosis
  • Aged

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Rehabilitation
  • Surgery

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