Question
What is the prevalence of anxiety post-stroke?
Answer
Anxiety disorders occur in about 20% to 27% of those who are post-stroke. When I looked at all of the research with all of the different anxiety disorders, I found there were so many different research designs and screening tools used to look at anxiety and stroke, that it was very hard to give you specific information on each of the disorders in relation to a person having a stroke. The commonalities of the anxiety disorders according to the DSM-IV are anxiety occurs without recognizable stimulus or when the stimulus does not warrant such a reaction. Symptoms that may occur with any of the anxiety disorders are ongoing worry, fear, restlessness, and irritability. You may also see a decreased energy, rapid heart rate, the person feeling panicky, looking panicky, being out of breath, headache, upset stomach, and decreased concentration. Functional deficits that you may observe include ADLs and IADLs deficits, difficulty attending or concentrating to a task, and decreased social engagement. They may want to stay more in their own room in the hospital, in their own home and not go out, or maybe have home health rather than going to outpatient clinic. They can have a decreased of quality of life.
When you look at major and minor depression and anxiety disorders without the incidence of a stroke, I am hoping you can see that there are a lot of areas that OT can be addressing, and then on top of these functional deficits, you add the complications associated with stroke. The underlying psychosocial sequelae can really impact how a person will do in therapy and what their motivation will be during therapy.
Editor’s note: This Ask the Expert was adapted from the course, ‘Depression and Other Psychosocial Disorders Associated with Stroke’ that is available in text and video course formats.
