Poststroke depression and emotional incontinence

Kim, Jong Seung; Choi-Kwon, Smi

doi:10.1212/wnl.54.9.1805

Cited by 252 publications

(205 citation statements)

References 34 publications

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“…Most research has focused on biological explanations with an association between emotional lability and frontal lesions found in four cohorts 36,[41][42][43] and an association with dorsal lesions in the other. 44 A Cochrane review of pharmacological interventions to treat emotional lability after stroke (seven trials, 739 people, recruited at 6 days to 13 years after stroke) reported that antidepressants reduced its frequency and severity but confidence intervals were wide (figure 2).…”

Section: Emotional Labilitymentioning

confidence: 99%

Neuropsychiatric outcomes of stroke

Hackett

Köhler

O’Brien

et al. 2014

The Lancet Neurology

262

148

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Section: Emotional Labilitymentioning

confidence: 99%

Neuropsychiatric outcomes of stroke

Hackett

Köhler

O’Brien

et al. 2014

The Lancet Neurology

262

148

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“…administered a structured questionnaire to patients and their relatives to establish the diagnosis of PSEI according to criteria of Kim and Choi-Kwon. 6 PSEI was considered present if patients showed excessive or inappropriate laughing, crying, or both compared with their premorbid state. If both the patient and cohabitating relative(s) agreed that excessive or inappropriate laughing or crying occurred on 2 or more occasions since the latest stroke, the diagnosis of PSEI was established.…”

Section: Diagnosis Of Pseimentioning

confidence: 99%

“…5 HRQOL has been used as an outcome measure in stroke research. 5 Determinants of stroke survivors' HRQOL include age, sex, 6 poststroke depression and anxiety, and physical function. 7 As a common poststroke complication, PSEI also may influence HRQOL adversely.…”

mentioning

confidence: 99%

Health-Related Quality of Life in Patients With Poststroke Emotional Incontinence

Chen¹,

Wong²,

Mok³

et al. 2011

Archives of Physical Medicine and Rehabilitation

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“…10 Afflicted individuals are often disinhibited or unable to control their emotional expressivity, and there is a disconnection between external stimuli and the emotional responses. 10,22,23 These reactions (which cause distress, embarrassment, and avoidance of social situations and have been linked to depression) 6,10,18,20 often occur in the first weeks after the stroke and are acute, short-lived, and intense. 2,11,20,24 These features differentiate them from other psychological reactions (e.g., anxiety and depression) that can become chronic.…”

Section: What Are the Psychological Reactions To Stroke And When Do Tmentioning

confidence: 99%

“…11 Although pseudobulbar affect has not been linked to the level of ADLs, it has been found to be more prevalent in individuals with severe motor dysfunction (weakness of the limbs) and in those who have suffered an ischemic stroke (as opposed to a hemorrhagic stroke). 22 Premorbid factors. Certain premorbid conditions may increase the risk of psychological reactions to stroke.…”

Section: Which Patients Are More Likely To Develop Adverse Psychologimentioning

confidence: 99%

The Recognition and Management of Psychological Reactions to Stroke

Chriki¹,

Bullain²,

Stern³

2006

Prim. Care Companion CNS Disord.

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ROUNDS IN THE GENERAL HOSPITALPrimwho is likely to cope poorly with physical impairments? Have you wondered how you can distinguish psychological reactions from neuropsychiatric and neurologic reactions? If you have, then the following case vignette (of a man who developed poststroke depression) should provide the forum for answers to these and other questions related to the psychological sequelae of stroke and comorbid neuropsychiatric syndromes. Cerebrovascular accidents (CVAs) disable thousands of people each year and are a major cause of death in this country. 1 CVAs lead to physical limitations in daily living and to psychological disorders, expressed in alterations to an individual's behavior and emotion. 2 However, in the recovery process after stroke, many patients and their caregivers focus on the patient's physical disabilities and fail to appreciate that the psychological complications of stroke can hinder a patient's recovery. Psychological reactions to stroke are manifested in myriad ways in the days, months, and years after a stroke. [2][3][4][5][6][7] Although not every patient develops intense emotional responses to stroke, those who do often have risk factors that make them more vulnerable to psychological consequences. 3,4,[8][9][10][11] Attention paid to those patients who may benefit from psychotherapeutic treatments as well as from psychotropic medications can facilitate effective treatment.The patient we present sustained a stroke and had severe psychological reactions to it. We will highlight symptom recognition, review the risk factors for distress and dysfunction, and discuss the treatment of psychological reactions to stroke. Case VignetteMr. B, a previously healthy, right-handed, 60-year-old man, suffered a CVA in his sleep. A sudden noise awakened him; his head ached, and he realized that he could barely move his right arm. Despite this, he managed to call for an ambulance. On arrival at the emergency room, his vital signs revealed a heart rate of 120 beats per minute, a respiratory rate of 26 breaths per minute, and a blood pressure reading of 172/112 mm Hg. The physical examination revealed decreased muscle tone, 1/5 muscle strength, and hyperreflexia in the right arm. A noncontrast computed tomography scan of Mr. B's head confirmed the diagnosis of stroke. Results of the rest of his examination were within normal limits. After 4 days in the hospital, Mr. B was discharged to his home and began a course of physical therapy as arranged by his family practitioner. Mr. B struggled to carry out the basic activities of daily living (ADLs); he had difficulty dressing himself and preparing his own food, and he was unable to write.

show abstract

Poststroke depression and emotional incontinence

Cited by 252 publications

References 34 publications

Neuropsychiatric outcomes of stroke

Neuropsychiatric outcomes of stroke

Health-Related Quality of Life in Patients With Poststroke Emotional Incontinence

The Recognition and Management of Psychological Reactions to Stroke

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