title: Impact of anxiety on health-related quality of life after stroke: a cross-sectional study.
abstract: OBJECTIVE
  To examine the impact of anxiety on health-related quality of life (HRQOL) of stroke survivors.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Acute stroke unit in a regional hospital.
  
  
  METHODS
  Patients (N=374) from an acute stroke unit.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The presence of anxiety was defined as a score of ≥8 on the anxiety subscale of the Hospital Anxiety Depression Scale. HRQOL was measured by the total score and 12 domain scores of the Stroke Specific Quality of Life (SSQOL) scale. Demographic characteristics and history of medical conditions were also recorded. Clinical characteristics were obtained using the following scales: National Institutes of Health Stroke Scale, Barthel Index, Mini-Mental State Examination, and Geriatric Depression Scale (GDS).
  
  
  RESULTS
  Eighty-six (23%) stroke survivors had anxiety. The anxiety group had significantly more women (62.8% vs 35.1%), higher GDS scores (7.5±4.5 vs 3.5±3.6), and lower scores for total SSQOL (3.9±0.6 vs 4.5±0.6) and SSQOL domains of energy (2.0±1.2 vs 3.4±1.4), mood (3.6±1.5 vs 4.6±0.9), personality (3.4±1.7 vs 4.4±1.1), and thinking (2.4±1.2 vs 3.5±1.4), after adjustment for sex and GDS score. In subsequent multivariate regression analysis, the Hospital Anxiety Depression Scale anxiety score was negatively associated with the SSQOL total score (r=-.154) and 5 of the 12 domain scores, namely energy (r=-.29), mood (r=-.102), personality (r=-.195), thinking (r=-.136), and work/productivity (r=-.096).
  
  
  CONCLUSIONS
  Anxiety has a negative effect on HRQOL of stroke survivors, independent from depression. Interventions for anxiety should improve stroke survivors' quality of life.
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: tangwk@cuhk.edu.hk.
authors.forename: Wai Kwong
authors.initials: WK
authors.lastname: Tang
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Chieh Grace
authors.initials: CG
authors.lastname: Lau
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Ka-Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012737:Sex Factors; D020521:Stroke / Q000523:psychology*
keywords: Anxiety; BI; Barthel Index; GDS; Geriatric Depression Scale; HADS; HRQOL; Hospital Anxiety Depression Scale; MMSE; Mini-Mental State Examination; Quality of life; Rehabilitation; SIS; SSQOL; Stroke; Stroke Impact Scale; Stroke Specific Quality of Life; health-related quality of life