CLINICAL CORRELATES OF EARLY-ONSET AND LATE-ONSET POSTSTROKE GENERALIZED ANXIETY

Objective: The authors' goal was to determine if generalized anxiety d iagnosed while a patient teas hospitalized for stroke (early onset) ba d the same clinical correlates as anxiety beginning 3 months or more a fter the stroke (late onset). Method: Patients with acute stroke (N=14 2) were examined while they were in the hospital and 3, 6, 12, and 24 months Inter 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-onse t and late-onset poststroke generalized anxiety were identified and co mpared to patients without poststroke generalized anxiety. Results: Th e frequency of early-onset-poststroke generalized anxiety was 27% and that of late-onset poststroke generalized anxiety was 23%. Three-quart ers of the anxious patients had comorbid major or minor depression. Pa tients who developed early-onset or late-onset poststroke generalized anxiety were no more socially, cognitively, or physically impaired tha n patients who did not develop anxiety. Early-onset but not late-onset anxiety was associated with a previous history of psychiatric disorde r. 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 sig nificantly associated with depression; onset of depression and onset o f anxiety occurred at approximately the same time. Conclusions: These findings suggest that although early-onset and late-onset poststroke g eneralized anxiety are phenomenologically similar, they may be the res ult of different pathophysiological mechanisms.