Pharmaceutical interventions for emotionalism after stroke

Allida, Sabine M; Patel, Kulsum; House, Allan; Hackett, Maree L.

doi:10.1002/14651858.cd003690.pub4

Cited by 14 publications

(18 citation statements)

References 69 publications

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“…185 A recent Cochrane review that included seven RCTs concluded that antidepressants (including SSRIs and TCAs) reduce the frequency and severity of crying episodes, though the quality of evidence was low. 186 Dextromethorphan/quinidine, the only drug currently approved specifically for emotionalism, was recently reported to be efficacious and well tolerated in an open-label study of stroke patients. 187…”

Section: Emotionalismmentioning

confidence: 99%

Neuropsychiatric Complications after Stroke

Nemani

Gurin

2021

Semin Neurol

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Neuropsychiatric disturbances represent a common and uniquely challenging consequence of stroke. These disorders arise at the intersection of lesion-related brain dysfunction and psychological distress related to the event and its aftermath, making it difficult to identify what symptom is a direct physiological consequence of the stroke. Depression, anxiety, fatigue, apathy, emotionalism, and anger are the most common of these syndromes, and posttraumatic stress disorder related to the stroke event has become increasingly recognized as a relevant entity. Mania, obsessive–compulsive disorder, and psychosis are less commonly encountered but potentially highly debilitating conditions that may be underrecognized. Early identification and treatment may mitigate functional impairment and improve quality of life. Evidence-based guidelines from the general population are often relied upon to guide treatment. Further research is needed to understand and tailor treatment of these disorders in the poststroke population.

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Section: Emotionalismmentioning

confidence: 99%

Neuropsychiatric Complications after Stroke

Nemani

Gurin

2021

Semin Neurol

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“…A reliable, valid scale will ensure post-stroke emotionalism is correctly detected and not confused with depression. 1 Post Stroke Emotionalism is characterised by lessening of ability to control emotional expression, in particular unheralded crying episodes not under personal control. 2,3 Developing a robust psychometric measure of emotionalism following stroke is an important development for stroke care.…”

Section: Introductionmentioning

confidence: 99%

Psychometric evaluation of a newly developed measure of emotionalism after stroke (TEARS-Q)

et al. 2020

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Objective: To evaluate, psychometrically, a new measure of tearful emotionalism following stroke: Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q). Setting: Acute stroke units based in nine Scottish hospitals, in the context of a longitudinal cohort study of post-stroke emotionalism. Subjects: A total of 224 clinically diagnosed stroke survivors recruited between October 1st 2015 and September 30th 2018, within 2 weeks of their stroke. Measures: The measure was the self-report questionnaire TEARS-Q, constructed based on post-stroke tearful emotionalism diagnostic criteria: (i) increased tearfulness, (ii) crying comes on suddenly, with no warning (iii) crying not under usual social control and (iv) crying episodes occur at least once weekly. The reference standard was presence/absence of emotionalism on a diagnostic, semi-structured post-stroke emotionalism interview, administered at the same assessment point. Stroke, mood, cognition and functional outcome measures were also completed by the subjects. Results: A total of 97 subjects were female, with a mean age 65.1 years. 205 subjects had sustained ischaemic stroke. 61 subjects were classified as mild stroke. TEARS-Q was internally consistent (Cronbach’s alpha 0.87). TEARS-Q scores readily discriminated the two groups, with a mean difference of −7.18, 95% CI (−8.07 to −6.29). A cut off score of 2 on TEARS-Q correctly identified 53 of the 61 stroke survivors with tearful emotionalism and 140 of the 156 stroke survivors without tearful emotionalism. One factor accounted for 57% of the item response variance, and all eight TEARS-Q items acceptably discriminated underlying emotionalism. Conclusion: TEARS-Q accurately diagnoses tearful emotionalism after stroke.

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“…1 There are reports of emotionalism following multiple sclerosis, 2 Parkinson's disease, 3 and amyotrophic lateral sclerosis, 4 but the condition is most prevalent following stroke. 5,6 The pathophysiological mechanisms underlying PSE have been the subject of much speculation. Several studies have implicated cortico-pontine-cerebellar circuit damage in the onset of the condition, specifically disruption to the cerebellum's role in modulating emotional responses and aligning them to fit contextual information from the cortex.…”

Section: Introductionmentioning

confidence: 99%

“…Antidepressant medication was shown to reduce frequency of uncontrolled crying in a Cochrane review. 5 The clinical benefits however are, at best, modest, and side effects are experienced in a significant proportion of patients who take them. It is for this reason that clinicians are advised to exercise caution when prescribing.…”

Section: Introductionmentioning

confidence: 99%

Non-pharmacological interventions for post-stroke emotionalism (PSE) within inpatient stroke settings: a theory of planned behavior survey

Gillespie

Cadden

West

et al. 2019

Topics in Stroke Rehabilitation

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Background: Post-stroke emotionalism (PSE) is common. Trials of antidepressants for PSE suggest only modest clinical benefit and risk of side effects. There have been no trials of non-pharmacological treatments for PSE; in fact, little is known about the non-pharmacological treatments actually provided to PSE sufferers in clinical practice. Objectives: To determine the non-pharmacological interventions provided by stroke professionals, their perceived effectiveness, and the factors associated with the intention to provide them. Methods: Focus groups and published sources of information were used to construct a comprehensive list of non-pharmacological approaches for PSE. This was followed by a national (online) survey of 220 UK stroke clinicians from nursing, medicine and the allied health professions to investigate the approaches used in clinical practice, using Theory of Planned Behavior components to determine the factors associated with intention to provide them. Results: Most respondents reported high intention to provide non-pharmacological interventions from the list that was constructed. Offering reassurance and talking to patients about goals were the commonest interventions, and distraction and tensing facial muscles least common. Respondents who perceived others to hold them professionally responsible for carrying out non-pharmacological approaches were more likely to use them, as were respondents who held more positive attitudes. Conclusions: Our survey data reveal that stroke clinicians report regular use of nonpharmacological interventions for PSE. There is a pressing need for well-conducted clinical trials to evaluate the effectiveness of these approaches. Key: Approaches identified from (a) published stroke guidelines; (b) stroke textbooks; (c) STARS website; (d) focus groups-see Methods for explanation

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Pharmaceutical interventions for emotionalism after stroke

Cited by 14 publications

References 69 publications

Neuropsychiatric Complications after Stroke

Neuropsychiatric Complications after Stroke

Psychometric evaluation of a newly developed measure of emotionalism after stroke (TEARS-Q)

Non-pharmacological interventions for post-stroke emotionalism (PSE) within inpatient stroke settings: a theory of planned behavior survey

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