Prevention of Post-Stroke Generalized Anxiety Disorder, Using Escitalopram or Problem-Solving Therapy
Abstract
Methods
Patients
Neurological and Neuroradiological Evaluations
Experimental Design and Treatment
Assessment Instruments and GAD Diagnosis
Adverse Events
Statistical Analysis
Results
Participants and Baseline Measures
Placebo (N=49) | Escitalopram (N=47) | PST (N=53) | |
---|---|---|---|
Age, mean (SD), yearsa | 64.8 (13.5) | 61.5 (13.7) | 68.3 (10.4) |
Male, % | 67.3 | 63.8 | 54.7 |
Married, % | 59.2 | 53.2 | 47.2 |
Education, mean (SD), years | 13.4 (2.9) | 13.4 (3.1) | 14.1 (2.9) |
Socioeconomic Class IV, Vb, % | 26.5 | 19.1 | 24.5 |
Previous history of GAD, % | 6.1 | 6.4 | 5.7 |
Baseline Hamilton Rating Scale for Anxiety score, mean (SD) | 6.8 (4.4) | 7.1 (5.6) | 8.3 (5.4) |
Baseline Functional Independence Measure (FIM) score, mean (SD) | 114.9 (20.7) | 115.8 (16.6) | 114.5 (13.7) |
Baseline Social Functioning Exam score, mean (SD) | 0.13 (0.12) | 0.12 (0.09) | 0.09 (0.09) |
Stroke characteristics, % | |||
Hemorrhagic stroke | 8.2 | 4.3 | 13.2 |
Ischemic stroke | 91.8 | 95.7 | 86.8 |
Large-artery atherosclerosis | 30.6 | 36.2 | 20.8 |
Small-artery occlusion | 32.7 | 17.0 | 30.2 |
Cardioembolism/Other | 28.6 | 42.6 | 35.8 |
Left-side lesion | 51.0 | 48.9 | 41.5 |
Medical comorbidity | |||
Systolic blood pressure, mean (SD), mm Hg | 144.0 (24.4) | 139.3 (24.1) | 146.9 (20.6) |
Low-density lipoprotein cholesterol, mean (SD), mg/dl | 122.5 (47.7) | 116.3 (37.0) | 109.9 (38.0) |
Cumulative Illness Rating Scale total score, mean (SD) | 9.7 (4.6) | 10.2 (5.4) | 9.5 (4.8) |
Diabetes mellitusc, % | 20.4 | 42.6 | 17.0 |
Coronary artery disease, % | 22.4 | 25.5 | 24.5 |
Cognitive heart failure, % | 6.1 | 14.9 | 13.2 |
Atrial fibrillation, % | 14.3 | 14.9 | 22.6 |
Effect of Preventive Intervention on GAD
Adjusted Hazard Ratio (HR) | 95% Confidence Interval (CI) for Hazard Ratio (HR) | p | |
---|---|---|---|
Placebo versus escitalopram | 4.95 | 1.54–15.93 | 0.0073 |
Placebo versus PST | 4.00 | 1.84–8.70 | 0.0005 |
Escitalopram versus PST | 0.81 | 0.12–5.26 | NS |
Age | 1.03 | 1.01–1.06 | 0.0097 |
Previous history of GAD | 3.59 | 7.74–4.64 | 0.0005 |
Female vs. male | 1.39 | 0.59–3.07 | NS |
Baseline Functional Independence Measure score | 1.03 | 0.96–1.10 | NS |
Adverse Events and Adverse Effects
Discussion
Acknowledgments
Footnote
References
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