Poststroke neuropsychiatric illness: An integrated approach to diagnosis and management

Bourgeois, James A.; Hilty, Donald M.; Chang, Celia H.; Wineinger, Mark A.; Servis, Mark E

doi:10.1007/s11940-996-0031-9

Cited by 24 publications

(16 citation statements)

References 80 publications

(9 reference statements)

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“…It is frequently associated with higher risk for a wide range of physical and neuropsychological consequences [2, 3]. Although the importance of poststroke psychiatric comorbidity is currently well documented, it had been previously underestimated [4].…”

Section: Introductionmentioning

confidence: 99%

Depression after Stroke and Risk of Mortality: A Systematic Review and Meta-Analysis

Bartoli

Lillia

Lax

et al. 2013

Stroke Research and Treatment

207

175

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Background. Depression after stroke may have great burden on the likelihood of functional recovery and long-term outcomes. Objective. To estimate the association between depression after stroke and subsequent mortality. Methods. A systematic search of articles using PubMed and Web of Science databases was performed. Odds ratios (ORs) and hazard ratios (HRs) were used as association measures for pooled analyses, based on random-effects models. Results. Thirteen studies, involving 59,598 subjects suffering from stroke (6,052 with and 53,546 without depression), had data suitable for meta-analysis. The pooled OR for mortality at followup in people suffering from depression after stroke was 1.22 (1.02–1.47). Subgroups analyses highlighted that only studies with medium-term followup (2–5 years) showed a statistically significant association between depression and risk of death. Four studies had data suitable for further analysis of pooled HR. The meta-analysis revealed a HR for mortality of 1.52 (1.02–2.26) among people with depression after stroke. Conclusions. Despite some limitations, this paper confirms the potential role of depression on post stroke mortality. The relationship between depression and mortality after stroke seems to be related to the followup duration. Further research is needed to clarify the nature of the association between depression after stroke and mortality.

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Section: Introductionmentioning

confidence: 99%

Depression after Stroke and Risk of Mortality: A Systematic Review and Meta-Analysis

Bartoli

Lillia

Lax

et al. 2013

Stroke Research and Treatment

207

175

View full text Add to dashboard Cite

show abstract

“…However, poststroke psychosis which is considerably rarer has not been adequately reported in the literature. Management of neuropsychiatric comorbidity following stroke forms an essential component of a comprehensive management plan for the patient 6. These disorders complicate recovery and rehabilitation of poststroke patients and predict poorer long-term prognosis.…”

Section: Discussionmentioning

confidence: 99%

Poststroke psychosis in an 8-year-old child with moyamoya disease

Gnanavel

2013

BMJ Case Reports

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Psychiatric illnesses following cerebrovascular accidents has been a popular area of research in recent times. Though poststroke anxiety and mood disorders including depression have been reported often, reports of poststroke psychosis have been considerably rarer. This case report documents an even rarer occurrence of a psychotic disorder in an 8-year-old child with moyamoya disease following a cerebrovascular accident. The child was managed with low-dose atypical antipsychotic, risperidone and the psychotic symptoms eventually were under control around 3 weeks following the initiation of psychotropic medication.

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“…24 The interaction between depression and neurological disease is complex. When depression precedes the onset of neurological disease, it is often unclear whether depression is the first manifestation of the illness or coincidentally preceded the onset of an ensuring brain disease.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of home rehabilitation for ischemic stroke

Chaiyawat

Kulkantrakorn²,

Sritipsukho

2009

Neurol Int

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The objective of this study was to develop and examine the effectiveness of an individual home rehabilitation program for patients with ischemic stroke. This was a randomized controlled trial in 60 patients with recent middle cerebral artery infarction. After hospital discharge for acute stroke care, they were randomly assigned to receive either a home rehabilitation program for three months (intervention group) or usual care (control group). We collected outcome data over three months after their discharge from the hospital. The Barthel Index (BI), the Modified Rankin Scale (MRS), the health-related quality-of-life index (EQ-5D), the Hospital Anxiety and Depression score (HADs), and the Thai Mental State Examination (TMSE) were used to analyze the outcomes. In the intervention group, all outcomes were significantly better (p<0.05) than in the control group, except in the case of TMSE. A favorable outcome, which was defined as minimal or no disability as measured by BI (score 95–100), was achieved by 93.33% of patients in the intervention group, and 90% had favorable scores (0 or 1) on the MRS. This showed a benefit in reducing disability, with two being the number of patients considered as needed-to-treat (NNT) (95% CI, 1.0–1.2). All dimensions of EQ-5D in the intervention group were significantly better for quality of life and generic health status than in the control group (p=0.001). Depression was found in one patient (3.33%) in the intervention group and in two patients (6.67%) in the control group. Dementia was found in three patients (10%) in the intervention group and in four patients (13.33%) in the control group. We concluded that an early home rehabilitation program for patients with ischemic stroke in the first three-month period provides significantly better outcomes in improving function, reducing disability, increasing quality of life, and reducing depression than a program of usual care does.

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Poststroke neuropsychiatric illness: An integrated approach to diagnosis and management

Cited by 24 publications

References 80 publications

Depression after Stroke and Risk of Mortality: A Systematic Review and Meta-Analysis

Depression after Stroke and Risk of Mortality: A Systematic Review and Meta-Analysis

Poststroke psychosis in an 8-year-old child with moyamoya disease

Effectiveness of home rehabilitation for ischemic stroke

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