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Anxiety Disorders After Stroke: Results from the Perth Community Stroke Study

Published online by Cambridge University Press:  02 January 2018

P. W. Burvill ,
G. A. Johnson ,
K. D. Jamrozik ,
C. S. Anderson ,
E. G. Stewart-Wynne  and
T. M. H. Chakera
P. W. Burvill*
Affiliation:
Department of Psychiatry and Behavioural Science, University of Western Australia
G. A. Johnson
Affiliation:
Department of Psychiatry and Behavioural Science, University of Western Australia
K. D. Jamrozik
Affiliation:
Department of Public Health, University of Western Australia
C. S. Anderson
Affiliation:
Department of Neurology, Royal Perth Hospital
E. G. Stewart-Wynne
Affiliation:
Stroke Unit, Royal Perth Hospital, Wellington Street, Perth, W. A. 6000
T. M. H. Chakera
Affiliation:
Department of Diagnostic Radiology, Royal Perth Hospital, Australia
*
Professor Burvill, Department of Psychiatry and Behavioural Science, University of Western Australia, Nedlands, W. A. 6009, Australia
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Abstract

Background

The prevalence of anxiety disorders in 294 patients who survived to four months in the Perth Community Stroke Study (Perth, Australia), and a follow-up of these patients at 12 months, are presented.

Method

Diagnoses are described both in the usual DSM hierarchic format and by a non-hierarchic approach. Adoption of the hierarchic approach alone greatly underestimates the prevalence of anxiety disorders.

Results

Most cases were of agoraphobia, and the remainder were generalised anxiety disorder. The prevalence of anxiety disorders alone was 5% in men and 19% in women; in community controls, it was 5% in men and 8% in women. Adopting a non-hierarchic approach to diagnosis gave a prevalence of 12% in men and 28% in women. When those who showed evidence of anxiety disorder before stroke were subtracted, the latter prevalence was 9% in men and 20% in women.

Conclusion

One-third of the men and half of the women with post-stroke anxiety disorders showed evidence of either depression or an anxiety disorder at the time of the stroke. At 12 month follow-up of 49 patients with agoraphobia by a non-hierarchic approach, 51 % had recovered, and equal proportions of the remainder had died or still had agoraphobia. The only major difference in outcome between those with anxiety disorder alone and those with comorbid depression was the greater mortality in the latter.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 3 , March 1995 , pp. 328 - 332
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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Footnotes

Current address: Department of Medicine (Neurology), Flinders Medical Centre, Bedford Park, S. A. 5042

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Anderson, C. S., Jamrozik, K. D., Burvill, P. W., et al (1993) Ascertaining the true incidence of stroke: experience from the Perth Community Stroke Study, 1989–1990. Medical Journal of Australia, 158, 80–84.CrossRefGoogle ScholarPubMed
Boyd, J. H., Burke, J. D., Gruenberg, E., et al (1984) Exclusion criteria of DSM–III. A study of co-occurrence in hierarchy-free syndromes. Archives of General Psychiatry, 41, 983–989.CrossRefGoogle ScholarPubMed
Burvill, P. W., Johnson, G. A., Jamrozik, K. D., et al (1995) The prevalence of depression after stroke: the Perth Community Stroke Study. British Journal of Psychiatry, 166, 320–327.CrossRefGoogle ScholarPubMed
Federoff, J. P., Starkstein, S. E., Parikh, R. M., et al (1991) Are depressive symptoms non-specific in patients with acute stroke? American Journal of Psychiatry, 148, 1172–1176.Google Scholar
Finlay-Jones, R. A. & Brown, G. W. (1981) Types of stressful life event and the onset of anxiety and depressive disorders. Psychological Medicine, 11, 803–815.CrossRefGoogle ScholarPubMed
Kay, D. W. K. (1988) Anxiety in the elderly. In Handbook of Anxiety. Vol. 2. Classification, Etiological Factors and Associated Disturbances (eds Noyes, R. Jr, Roth, M. & Burrows, G. D.), pp. 289–310. Amsterdam: Elsevier.Google Scholar
Larkin, B. A., Copeland, J. R. M., Dewey, M. E., et al (1992) The natural history of neurotic disorder in the elderly urban population. British Journal of Psychiatry, 160, 681–686.CrossRefGoogle ScholarPubMed
Lindesay, J. (1991) Phobic disorders in the elderly. British Journal of Psychiatry, 159, 531–541.CrossRefGoogle ScholarPubMed
Lipsey, J. R., Spencer, W. C., Rabins, P. V., et al (1986) Phenomenological comparison of post-stroke depression and functional depression. American Journal of Psychiatry, 143, 527–529.Google Scholar
Morris, P. L. P., Robinson, R. G., Andrzejewski, P., et al (1993) Association of depression with 10-year post-stroke mortality. American Journal of Psychiatry, 50, 124–129.Google Scholar
Robinson, R. G. & Starkstein, S. E. (1991) Heterogeneity in clinical presentation following stroke: Neuropathological correlates. Neuropsychiatry, Neuropsychology and Behavioural Neurology, 4, 4–11.Google Scholar
Starkstein, S. E. & Robinson, R. E. (1989) Affective disorders and cerebral vascular disease. British Journal of Psychiatry, 154, 170–182.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
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