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The effect of anxiety disorder on recovery from impairment following stroke was examined in 142 patients with acute stroke who had follow-up evaluations. Anxiety disorder significantly interacted with depression to influence the severity and course of depression, outcome of activities of daily living, and social functioning. Anxiety disorder, however, did not affect cognitive impairment, which was influenced only by major depression. These data suggest that the existence of anxiety disorders plays an important role in the prognosis of patients with poststroke depression. These data also suggest that depression and anxiety disorder may have different mechanisms.

Prior studies have identified that quality of social functioning is strongly associated with both physical and cognitive recovery from stroke as well as with the existence of depression. This study was undertaken to identify the specific elements of social functioning that are related to depression and impaired recovery and to determine whether these elements are different between acute and chronic periods following stroke. There were 50 patients with acute stroke who were assessed in the hospital and at short-term (3- or 6-month) and long-term (12- or 24-month) follow-up. An impaired relationship with the patient's “closest other” prior to the stroke and limited social activities were both associated with depression immediately after the stroke as well as with depression at long-term follow-up. An impaired relationship with the closest other prior to the stroke was also associated with impaired recovery in activities of daily living and cognitive recovery at long-term follow-up. Fears of economic stability and limited social activity were associated with depression at short-term follow-up whereas loss of job or job satisfaction was associated with depression at long-term follow-up. These findings suggest that during the first few weeks following stroke, social supports and contact are essential needs for patients, whereas during the chronic period, other factors such as financial security, adequacy of living arrangements, and loss of job satisfaction also become important. Future research should examine the effect of enhanced social support on poststroke depression and physical and cognitive recovery.