Anxiety after stroke: A systematic review and meta-analysis

Abstract

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.