Psychiatric morbidity in stroke patients attending a neurology clinic in Nigeria

Abstract

Back ground: Stroke produces a wide range of mental and emotional disorders. Neuropsychiatric complications associated with stroke may have negative effects on the social functioning, overall quality of life and the recovery of motor functioning of stroke survivors. Objective: To determine the prevalence and nature of psychiatric morbidity among stroke patients attending neurology outpatient clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin-Nigeria. Methods: All patients with stroke aged 18 years and above at an outpatient neurology clinic in Ilorin, Nigeria were assessed for mental and emotional disorders using the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) over one year (March 2009 to February 2010. Results: Overall prevalence of psychiatric morbidity was 36.0% (30/83) among 83 patients who constituted the study population. Specific diagnoses recorded were depression (19.2%), generalised anxiety disorder (9.6%), harmful alcohol use (2.4%); dementia, somatoform disorder, phobia and delusional disorder each had a prevalence of 1.2%. Clinical and sociodemographic variables were not significantly associated with psychiatric morbidity. Conclusion: Psychiatric disorders are often associated with stroke. Identifying and treating stroke patients with these psychiatric co-morbidities could thus help to improve the overall quality of life of these patients.

Depression after Stroke in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

“…While most relied on a variety of rating scales, clinical interview and formal diagnostic criteria were used in five studies [ 16 , 24 , 26 , 28 , 30 ]. Only one of these studies [ 30 ] used the criteria in the 10th revision of the International Classification of Diseases (ICD-10) [ 31 ]. The other studies using clinical diagnostic criteria relied on the Diagnostic and Statistical Manual of Mental Disorders [ 32 ].…”

“…Notably, only one study [ 17 ] included participants recruited from their homes, rather than in hospital or physical rehabilitation settings. The remaining eight studies were conducted among medical inpatients [ 20 – 22 ] or outpatients [ 3 , 25 , 27 , 30 ].…”

“…There was an indication of statistical heterogeneity in this estimate ( I 2 = 85.1%, p < 0.001). This was due to one study [ 30 ] reporting an unusually low prevalence of PSD in a Nigerian medical outpatient clinic ( Figure 2 ). That study was the only study in the present review using the ICD-10 criteria.…”

“…That study was the only study in the present review using the ICD-10 criteria. It is unclear whether, or how, this ascertainment procedure might have affected the results of that study [ 30 ]. In analyses conducted to minimize heterogeneity (Figures 3 and 4 ), there were no remarkable differences in pooled rates reported across healthcare settings.…”

Post-stroke depression: Prevalence, associated factors and impact on quality of life among outpatients in a Nigerian hospital

“…Earlier reviews showed PSD to be the commonest mental disorder in survivors, with up to 25.5% prevalence rate reported in previous local studies. 10 , 11 , 12 Additionally, studies have shown significant associations between emotional disorders like depression and poorer quality of life (QoL) in stroke survivors. 13 , 14 Such comorbidity of stroke with depression has been described as the ‘double burden’ of stroke because both depression and stroke are leading contributors to total years lost to disability based on the global burden of diseases report.…”