Prevalence and Factors of Anxiety and Depression in Young Stroke Survivors
Overview
This meta-analysis of 26 studies including 5,634 young stroke patients found that both anxiety and depression affect approximately 35% of this population. Key factors associated with depression include neurological severity, lesion characteristics, vascular comorbidities, and psychosocial elements, while alcohol consumption and prior depressive symptoms are linked to anxiety.
Background
Stroke is a leading cause of death and disability worldwide, increasingly recognized in younger adults aged 15–60 years. Young stroke survivors face unique challenges due to longer life expectancy and disruptions in critical life stages such as career and family development. Anxiety and depression are common neuropsychiatric complications post-stroke, but their prevalence and contributing factors in young stroke patients have not been well characterized. This study aims to fill that gap by systematically reviewing and analyzing relevant data.
Data Highlights
Parameter
Prevalence (%)
95% Confidence Interval
Anxiety (overall)
35
29–41
Depression (overall)
35
29–41
Anxiety (2005–2018)
32
Depression (2005–2018)
33
Anxiety (2019–2025)
43
Depression (2019–2025)
32
Anxiety (China)
35
Depression (China)
34
Anxiety (Other countries)
36
Depression (Other countries)
30
Anxiety (First-ever stroke)
32
Depression (First-ever stroke)
31
Anxiety (Non-first-ever stroke)
37
Depression (Non-first-ever stroke)
34
Anxiety (Male)
32
Depression (Male)
36
Anxiety (Female)
43
Depression (Female)
37
Key Findings
The pooled prevalence of anxiety and depression in young stroke patients is 35% each.
Alcohol consumption is a common factor associated with both anxiety and depression.
Neurological severity (NIHSS score), lesion location and area, and multiple lesions significantly influence depression risk.
Vascular comorbidities such as hypertension, diabetes, and hyperlipidemia are associated with increased depression risk.
Psychosocial factors including stroke-related shame and lower hope (HHI score) are linked to depression.
Gender differences were noted but findings were not stable upon sensitivity analysis.
Clinical Implications
Routine psychological assessment for anxiety and depression should be integrated into the care of young stroke survivors given the high prevalence. Attention to modifiable factors such as alcohol use and management of vascular risk factors may help mitigate depression risk. Clinicians should consider lesion characteristics and psychosocial context when planning interventions.
Conclusion
Anxiety and depression are common and clinically significant in young stroke survivors, influenced by a complex interplay of neurological, vascular, and psychosocial factors. Enhanced screening and targeted interventions are warranted to address mental health in this vulnerable population.
