Assessing anosognosia: a critical review

Cocchini, Gianna; Beschin, Nicoletta; Sala, Sergio Della

doi:10.5604/17307503.1023693

Cited by 14 publications

(24 citation statements)

References 90 publications

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“…Anosognosia for motor and language deficits has rarely been investigated in the same study (e.g., Breier et al, 1995), and this may be due to the fact that these types of anosognosia are usually assessed with very different methods (for a review, see Cocchini, Beschin, & Della Sala, 2012). When a self-report method has been used, assessment consisted of an oversimplified measure (e.g., "clear negative response to the question, Did you notice any difficulty with speech after .…”

Section: Discussionmentioning

confidence: 98%

Relationship between anosognosia and depression in aphasic patients

Cocchini

Crosta

Allen

et al. 2013

Journal of Clinical and Experimental Neuropsychology

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Depression and reduced awareness of illness (anosognosia) can be frequent complications following a brain lesion but the relationship between these two syndromes is still unclear. While some researchers suggested a protective function of anosognosia from depression, others deny a functional relationship. We investigated anosognosia and depression in a group of 30 left-brain-damaged patients using specialized methodology for aphasic patients. We observed that anosognosic patients showed levels of depression comparable to those of aware patients and that anosognosia was highly selective for specific deficits. Our findings suggest that reduced awareness for a deficit does not play a crucial role in mood disorder, whereas "simply" suffering for a deficit can per se increase the likelihood of depression. Moreover, whereas depressed and nondepressed patients did show a similar impairment on the nonverbal executive function test, almost all patients showed anosognosia associated with impairment on executive functions. Finally, depressed patients tend to deny or minimize their own mood disorder, confirming that anosognosia can also concern mood status and that self-rating measures for depression could be quite controversial.

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Section: Discussionmentioning

confidence: 98%

Relationship between anosognosia and depression in aphasic patients

Cocchini

Crosta

Allen

et al. 2013

Journal of Clinical and Experimental Neuropsychology

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“…One of the most often-repeated phrases concerning unawareness, even within the relatively circumscribed field of anosognosia for hemiplegia, is that it is a heterogeneous or multi-faceted disorder, both in terms of its clinical presentation and neurological correlates (Cocchini, Beschin & Della Sala, 2012;Orfei et al, 2007;Vocat, Staub, Stroppini, & Vuilleumier, 2010). However, there are certain clinical or cognitive features that characterise anosognosic patients, and which different neuropsychological models emphasise to varying extents.…”

Section: Anosognosia For Hemiplegia (Ahp): Hemispheric Asymmetry and mentioning

confidence: 99%

“…The timing of the assessment is also crucial. Given that anosognosia typically resolves quite rapidly over the initial days or weeks after a stroke (Jehkonen et al, 2000;Starkstein, Jorge & Robinson, 2010), the prevalence of AHP is likely to be far higher where patients are recruited soon after the injury (Cocchini et al, 2012). This is highlighted by studies that measure anosognosia in the same patients over several time points, which typically report greater levels of unawareness during the early stage assessments (Jehkonen et al, 2001), to the extent that some commentators have suggested that, far from being a rare phenomenon, anosognosia may actually be a "'usual' state after severe brain damage" (Vocat, et al, 2010, p. 3591).…”

Section: Prevalence and Impact On The Lives Of Patients And Caregiversmentioning

confidence: 99%

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Health professionals are unaware of anosognosia

Fowler

Hart

McIntosh

et al. 2013

Cognitive Neuroscience

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"Implicit awareness" may be inferred from compliance with medical treatment, even when the patient explicitly denies the need for treatment. Such compliance may cause medics and other health professionals to underestimate the frequency of anosognosia and its effects on the lives of patients and carers. We report survey data showing that health professionals do indeed consider anosognosia following stroke to be relatively uncommon and unimportant, in contrast with evidence on its true frequency and impact. Mograbi and Morris' emphasis on the distinction between implicit and explicit awareness may promote increased recognition of anosognosia amongst health professionals.

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“…In addition to serious limitations of movement, most patients experience various cognitive and emotional disturbances caused by extensive brain damage. The difficult situation faced by every patient with a serious bodily injury becomes even more difficult when, in addition to the functional deficits, the patient has also lost the ability to solve problems or to plan and perform even the simplest activities [4,5,8–10]. As the patients themselves often explain, they must “learn to live all over again” [11–13].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI

et al. 2013

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BackgroundDifficulties in self-care constitute a very common problem for patients recovering from prolonged coma after a severe TBI, and a major factor reducing their quality of life. Effective new rehabilitation programs that would help solve this problem are urgently needed. The purpose of our experiment was to evaluate improvement in this respect in a group of patients aroused from prolonged coma who participated in a goal-oriented rehabilitation program (Rehab-3), enhanced with selected elements of Tai-Chi.Material/MethodsWe examined 40 patients aroused from prolonged coma after a severe TBI, undergoing long-term rehabilitation according to a standard phased rehabilitation program. These patients were divided into two numerically even groups: a control group treated according to the standard program, and an experimental group, who received an additional goal oriented program enhanced with selected Tai-Chi exercises. The research methods included analysis of documentation (MRI, CT), a structured clinical interview, and the Standard Self-Care Scale.ResultsThe experimental group achieved significant improvement of self-care skills, whereas in the control group the improvement was slight and not statistically significant. The value of co-efficient j (0.64) indicates a very strong association between the rehabilitation procedure and improved self-care in the experimental group, but not in the control group.ConclusionsOur results confirmed that a goal-oriented rehabilitation program enhanced with elements of Tai-Chi was more effective than the standard program in improving the performance of activities of daily living.

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Assessing anosognosia: a critical review

Cited by 14 publications

References 90 publications

Relationship between anosognosia and depression in aphasic patients

Relationship between anosognosia and depression in aphasic patients

Health professionals are unaware of anosognosia

The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI

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