Assessment of Select Dimensions of Patients' Emotional Functioning at Different Time Periods After Stroke

Zawadzka, Ewa; Domańska, Łucja

doi:10.1080/09084282.2012.747959

Cited by 6 publications

(6 citation statements)

References 37 publications

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“…In previous studies, an increased risk of depression 13–15 and anxiety 11 was noted after diagnosis of stroke, 11,13–15 hypertension, 17 coronary artery disease 31 and atrial fibrillation. 32 Such risk elevations has been suggested to be persistent over time, 10,33,34 and, in parallel with our findings, associated with compromised survival. 8,35,36 However, the evidence from prospective cohort studies with a long and complete follow-up as well as with a thorough control of confounding factors and comorbid conditions has, up to this point, been limited.…”

Section: Discussionsupporting

confidence: 89%

Cardiovascular disease and subsequent risk of psychiatric disorders: a nationwide sibling-controlled study

Shen

Song

Aspelund

et al. 2022

Preprint

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Background The association between cardiovascular disease (CVD) and selected psychiatric disorders has frequently been suggested while inadequate control of familial factors and comorbidities has halted causal inferences. Methods We identified 869 056 patients newly diagnosed with CVD from 1987 to 2016 in Sweden while no history of psychiatric disorders, and 910 178 full siblings of these patients and 10 individually age- and sex-matched unrelated population controls (N=8 690 560). Adjusting for multiple comorbid conditions, we used flexible parametric models and Cox regression to estimate the association of CVD with risk of all subsequent psychiatric disorders, comparing rates of first incident psychiatric disorder among CVD patients with rates among unaffected full siblings and population controls. Results The median age at diagnosis was 60 years for patients with cardiovascular disease and 59.2% were male. During up to thirty years of follow-up, the crude incidence rates of psychiatric disorder were 7.1, 4.6 and 4.0 per 1000 person-years for patients with cardiovascular disease, their siblings and population controls. In the sibling comparison, we observed an increased risk of psychiatric disorder during the first year after cardiovascular diagnosis (hazard ratio [HR], 2.74; 95% confidence interval [CI], 2.62-2.87) and thereafter (1.45; 95% CI, 1.42-1.48). Increased risks were observed for all types of psychiatric disorders and among all diagnoses of cardiovascular disease. We observed similar associations in the population comparison. Cardiovascular patients who developed a comorbid psychiatric disorder during the first year after diagnosis were at increased risk of subsequent cardiovascular death compared to patients without such comorbidity (HR 1.55; 95% CI 1.44-1.67). Conclusions Patients diagnosed with cardiovascular disease are at an elevated risk for subsequent psychiatric disorders independent of familial factors and comorbid conditions. Cardiovascular patients with comorbid psychiatric disorders are at increased risk of cardiovascular mortality suggesting that surveillance and treatment of psychiatric comorbidities should be considered as an integral part of clinical management of newly diagnosed patients with cardiovascular disease. Funding: This work was supported by the EU Horizon 2020 Research and Innovation Action Grant (CoMorMent, Grant nr. 847776 to UV, PFS and FF), Grant of Excellence, Icelandic Research Fund (grant no. 163362-051 to UV), ERC Consolidator Grant (StressGene, grant no: 726413 to UV), Swedish Research Council (Vetenskapsrådet, award D0886501 to PFS) and US NIMH R01 MH123724 (to PFS).

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Section: Discussionsupporting

confidence: 89%

Cardiovascular disease and subsequent risk of psychiatric disorders: a nationwide sibling-controlled study

Shen

Song

Aspelund

et al. 2022

Preprint

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“…The mismatches (over-and under-estimations) between observational and self-reported outcome measures could be attributed to different causes. Underestimations of self-reported capacity in the first 3 months may be associated with a more pronounced disturbed self-awareness (20), a limited insight into one's own functioning (19), more negativity-prone thoughts, and lack of information about the rehabilitation phase. Another possibility is that the improved, but affected, upper limb capacity is insufficiently used in daily activities, so that functional recovery is not fully experienced.…”

Section: Proportion Of Matches Between Observational and Self-reporte...mentioning

confidence: 99%

“…For the first aim, it was hypothesized that there would be a higher proportion of matches at 3-6 months than at 0-3 months post-stroke, because patients gradually learn to deal better with and gain more experience of real-world limitations, with a better understanding of their own capabilities (19)(20)(21). For the second aim, it was hypothesized that more patients would overestimate ("optimistic"') than underestimate ("pessimistic") their self-reported capacity at 0-3 months post-stroke than at 3-6 months post-stroke, because spontaneous neurological and functional recovery occurs within the first 3 months post-stroke.…”

mentioning

confidence: 99%

Patients self-reported versus objective clinical measures of improvement of upper limb capacity after stroke: Are they matching?

Lieshout¹,

Visser‐Meily²,

Nijland³

et al. 2020

J Rehabil Med

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One of the most common motor disturbances after stroke is a paretic arm, which may be of little functional use in activities of daily living. Recovery of the paretic arm can be assessed by a clinician (observational) or by the patient (patient-reported). It might be expected that observational and patient-reported measures will be strongly related to each other. The aim of this study was to determine whether the correspondence (matches) between those measures is different at 0-3 months post-stroke compared with 3-6 months post-stroke. The results showed that the time-frame post-stroke (0-3 or 3-6 months) did not seem to influence the correspondence between the observational and self-reported measures: there were more matches than mismatches found. Selfreported measures can be used in addition to observational measures to assess arm recovery. Information on the ability and use of the affected arm outside the treatment setting is valuable for clinicians, as it provides more insight into the patients' perspective. Objective: Recovery of the paretic arm post-stroke can be assessed using observational and self-reported measures. The aim of this study was to determine whether the correspondence (match) or non-correspondence (mismatch) between observational and self-reported improvements in upper limb capacity are significantly different at 0-3 months compared with 3-6 months post-stroke. Methods: A total of 159 patients with ischaemic stroke with upper limb paresis were included in the study. Recovery of arm capacity was measured with observational (Action Research Arm Test; ARAT) and self-reported measures (Motor Activity Log Quality of Movement; MAL-QOM and Stroke Impact Scale Hand; SIS-Hand) at 0-3 and 3-6 months post-stroke. The proportion of matches was defined (contingency tables and Fisher's exact test) and compared across the different time-windows using McNemar's test. Results: The proportion of matches was not significantly different at 0-3 months compared with 3-6 months post-stroke for the ARAT vs MAL-QOM and SIS-Hand (all p > 0.05). In case of mismatches, patients' self-reports were more often pessimistic (86%) in the first 3 months post-stroke compared with the subsequent 3 months (39%). Conclusion:The match between observational and self-reported measures of upper limb capacity is not dependent on the timing of assessment post-stroke. Assessment of both observational and self-reported measures may help to recognize possible over-or under-estimation of improvement in upper limb capacity post-stroke.

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“…According to Zawadzka and Domańska (2014) and to Kim (2016), the most frequent emotional changes after stroke include depression. In this line of thought, Hackett and Pickles (2014) demonstrated that during the first-year after stroke, between 31 and 33% of patients had depression, and between the first and fifth year after stroke, the proportion of patients with depression was 25%.…”

Section: Introductionmentioning

confidence: 99%

“…The studies comparing the prevalence of depression after 12 months (chronic period) are scarcer. Recently, Zawadzka and Domańska (2014) have shown that there is a decrease in symptomatology of depression after the first year; however, it may increase again after two or three years. On the other hand, Liman et al (2012) found similar prevalence of depression for the chronic period (after three and five years: 10.0 and 9.6% respectively) and for the medium duration period (at 12 months: 11.4%).…”

Section: Introductionmentioning

confidence: 99%

Symptomatology of Depression and Anxiety After Ischemic Stroke in Different Evolution Periods

Fernandes

Ascorra

Santos³

et al. 2018

Psychologist Practice & Research

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Background: Several studies suggest a high prevalence of symptoms of depression and anxiety after stroke. However, the prevalence and severity of this symptomatology may vary according to the period after a stroke in which the patient is assessed. Goals: This study aims to compare the depressive and anxious symptoms of a population of patients who suffered from ischemic stroke and who are in different evolution periods after stroke.Methods: This is an observational cross-sectional study. Participants were all individuals with ischemic stroke, without previous history of psychiatric disease nor pathologies involving Central Nervous System compromise or cognitive deficits, recruited from hospitals or from support units of the Rede Regional de Cuidados Continuados Integrados of the Região Autónoma da Madeira, Portugal. Participants were divided into four groups according to the post- stroke evolution period: short duration (0 to 3 months after the stroke), medium duration (4 to 12 months), chronic period I (13 to 24 months) and chronic period II (more than 24 months after the stroke). Data were collected by a psychologist, with the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory, Form Y (STAI-Y), in individual self-report sessions. Results: The study included 42 patients with ischemic stroke, 52.4% males, aged 55-88 years. The different post-stroke evolution period groups do not differ in age, sex, level of education, hemispheric location of the lesion or cognitive functioning. The results showed that the prevalence of depression is higher in the chronic group II; regarding the prevalence of anxiety, no significant differences were found between the four groups. As for the severity of symptoms of depression, it is also significantly higher in the chronic group II. With regard to anxiety, trait and state anxiety levels are higher in the medium duration group compared to participants in the short duration period. It was also observed higher levels of state anxiety in the medium duration group compared to the chronic group I. Discussion: These results suggest the need to identify early emotional changes inherent to this population. These changes can have a major impact on the assessment, follow-up and neuropsychological rehabilitation of patients, so that their early identification will allow a more adequate intervention.Keywords: Ischemic stroke; Depression; Anxiety; Emotional changes.

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Assessment of Select Dimensions of Patients' Emotional Functioning at Different Time Periods After Stroke

Cited by 6 publications

References 37 publications

Cardiovascular disease and subsequent risk of psychiatric disorders: a nationwide sibling-controlled study

Cardiovascular disease and subsequent risk of psychiatric disorders: a nationwide sibling-controlled study

Patients self-reported versus objective clinical measures of improvement of upper limb capacity after stroke: Are they matching?

Symptomatology of Depression and Anxiety After Ischemic Stroke in Different Evolution Periods

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