Anxiety and depression after stroke: a 5 year follow-up

Disabil Rehabil. 2013 Jan;35(2):140-5. doi: 10.3109/09638288.2012.691939. Epub 2012 Jun 22.


Purpose: The aim was to document the prevalence and predictors of anxiety and depression 5 years after stroke, across four European centres.

Method: A cohort of 220 stroke patients was assessed at 2, 4 and 6 months and 5 years after stroke. Patients were assessed on the Hospital Anxiety and Depression Scale and measures of motor function and independence in activities of daily living.

Results: At 5 years, the prevalence of anxiety was 29% and depression 33%, with no significant differences between centres. The severity of anxiety and depression increased significantly between 6 months and 5 years. Higher anxiety at 6 months and centre were significantly associated with anxiety at 5 years, but not measures of functional recovery. Higher depression scores at 6 months, older age and centre, but not measures of functional recovery, were associated with depression at 5 years.

Conclusions: Anxiety and depression were more frequent at 5 years after stroke than at 6 months. There were significant differences between four European centres in the severity of anxiety and depression. Although the main determinant of anxiety or depression scores at 5 years was the level of anxiety or depression at 6 months, this accounted for little of the variance. Centre was also a significant predictor of mood at 5 years. There needs to be greater recognition of the development of mood disorders late after stroke and evaluation of variation in management policies across centres.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology*
  • Anxiety / etiology
  • Anxiety / psychology
  • Depression / epidemiology*
  • Depression / etiology
  • Depression / psychology
  • Europe / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Psychiatric Status Rating Scales
  • Quality of Life / psychology
  • Regression Analysis
  • Severity of Illness Index
  • Stroke / psychology*
  • Time Factors