Stroke survivors with severe mental illness: Are they at-risk for increased non-psychiatric hospitalizations?

Lilly, Flavius R.W.; Culpepper, J Wesley; Stuart, Mary; Steinwachs, Donald M.

doi:10.1371/journal.pone.0182330

Cited by 7 publications

(5 citation statements)

References 47 publications

(53 reference statements)

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“…The physical effects of stroke are obvious, but the psychological effects are not always viable. A previous cohort study indicated that prestroke hospitalization was significantly related to severe mental illness (Lilly, Culpepper, Stuart, & Steinwachs, 2017). The current study clearly demonstrated low psychological scores among patients with stroke.…”

Section: Discussionmentioning

confidence: 99%

Social support, functional outcome and quality of life among stroke survivors in an urban area

Butsing

Tipayamongkholgul

Ratanakorn

et al. 2019

Journal of Pacific Rim Psychology

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Sophisticated medical technologies can prolong a stroke patient’s life but not always their quality of life (QoL) due to poor functional outcomes. Social support can theoretically assist a patient’s adaptation to life after stroke and improve their QoL, but existing findings are inconclusive. This inconclusiveness is especially found in large cities where family and social bonding can be scarce. We conducted a hospital-based, cross-sectional study among 358 stroke patients to identify the effects of social support and functional outcome on QoL and its domains. The study took place in Bangkok, Thailand between July and December 2016. Data were collected by personal interview using a structured questionnaire that included the Short-Form WHO Quality of Life Instrument (WHOQOL-BREF) and by review of medical records. A hierarchical linear regression method was used to analyze data. The mean age of stroke respondents was 66.0 years (SD 13.5 years), and half were male. The mean total QoL score for patients was 68.6 (SD 15.2). Hierarchical multiple regression analysis found emotional support significantly impacted QoL in every domain (ps < .05) when all included variables were controlled for. To improve the quality of life among stroke survivors, health personnel and family members should provide not only physical assistance but also psychological support.

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Section: Discussionmentioning

confidence: 99%

Social support, functional outcome and quality of life among stroke survivors in an urban area

Butsing

Tipayamongkholgul

Ratanakorn

et al. 2019

Journal of Pacific Rim Psychology

View full text Add to dashboard Cite

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“…Liao et al51 found higher rates of postoperative complications and mortality rates in patients suffering from schizophrenia . Data unadjusted for sociodemographics and comorbidity indicate that mentally ill stroke survivors were more frequently hospitalized for nonpsychiatric reasons prior to and up to one year after their initial stroke 52. Patients with atrial fibrillation and schizophrenia or severe depression experienced increased rates of stroke and major bleeding compared with matched comparisons,53 and coagulation control is poorer in mentally ill patients 54.…”

Section: Discussionmentioning

confidence: 99%

<p>Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke</p>

Hoyer

Schmidt

Kranaster

et al. 2019

NDT

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Background and purpose The comorbidity of psychiatric disorders and cerebrovascular disease appears to be complex with underlying bidirectional influences. Hitherto, research has focused mainly on the evaluation of stroke risk in particular psychiatric disorders; only a few studies have assessed their role in the acute natural history of stroke. The aim of this study was to provide a perspective on psychiatric premorbidity and its impact on stroke severity, psychiatric complications during the initial treatment phase, and the short-term functional outcome of stroke. Patients and methods We retrospectively studied the impact of a predocumented psychiatric diagnosis (PDPD) on stroke severity, short-term functional outcome, and psychiatric complications in a sample of 798 patients consecutively admitted for acute ischemic or hemorrhagic stroke by performing a chart review. Group comparisons (PDPD vs non-PDPD) with adjustment for covariates were carried out either using multivariate analysis of variance or logistic regression analysis. Results More severe strokes (ie, mean National Institute of Health Stroke Scale score on admission 10.1±7.9 vs 7.5±7.4; F(10,796)=18.5, p <0.0001) and higher prevalence of poor outcome (73.7 vs 54.9%; OR: 2.6, standard error: 0.5, z=4.82, p <0.0001) was found in patients with a documented psychiatric diagnosis at the time of stroke, as well as a higher rate of psychiatric complications during the initial treatment phase (46.7 vs 28.9%; OR: −0.78, z=4.59, p <0.0001). Conclusion Our data have clinical implications in that they call for identification of psychiatric premorbidity or comorbidity through careful history-taking and particularly close monitoring for psychiatric complications with respect to their potentially negative impact on outcome after stroke.

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“…This patient population is at increased risk for metabolic issues, such as obesity, which may have a modest effect on PPH risk. [26][27][28][29][30][31][32] The serotonergic agents used in mental health disorders may interfere with platelet aggregation and adhesion, increasing the risk for hemorrhage. 33,34 It is also possible that the mood disorder itself may impact serotonin transmission resulting in platelet dysfunction and subsequent bleeding.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of complications associated with postpartum hemorrhage up to 1 year postpartum in mothers with and without a pre-existing mental health diagnosis

Endres,

Razavi,

Tian

et al. 2023

Womens Health (Lond Engl)

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Background/objectives: There is limited research on the associated immediate and long-term outcomes of postpartum hemorrhage. Mothers with a pre-existing psychiatric disease prior to delivery may be especially vulnerable to postpartum hemorrhage outcomes but little is known on this topic. Barriers to studying this population exist and add to knowledge gaps. The goal of this study is to determine the clinical characteristics and frequency of complications within 1 year of a postpartum hemorrhage diagnosis and the psychiatric sequelae within 7 days of a postpartum hemorrhage diagnosis in mothers with a pre-existing mental health diagnosis prior to delivery versus those without. Methods/design: This is a multicenter retrospective observational cohort study using TriNetX, a de-identified electronic health record database. The following electronic health record data were collected and evaluated in postpartum females who were billed for either a vaginal or cesarean delivery: age, race, ethnicity, diagnostic codes, medication codes, and number of deaths. Results: We included 10,649 subjects (6994 (65.7%) no mental health diagnosis and 3655 (34.3%) pre-existing mental health diagnosis). Haloperidol administration (118 (3.2%) versus 129 (1.8%), p < 0.001) was more prevalent in subjects with a pre-existing mental health diagnosis. Adjusting for demographics, pre-existing mental health diagnoses were associated with complications within 1 year after postpartum hemorrhage diagnosis (OR = 1.39, 95% CI: 1.26–1.52, p < 0.001). Conclusion: Having a mental health disorder history is associated with a higher odds of developing subsequent complications within 1 year of postpartum hemorrhage diagnosis. Mothers with a pre-existing mental health disorder have a significantly higher frequency of certain severe postpartum hemorrhage sequelae, including acute respiratory distress syndrome, retained placenta, sickle cell crisis, and need for mechanical ventilation/tracheostomy up to 1 year after delivery. Medications such as haloperidol were ordered more frequently within 7 days of a postpartum hemorrhage diagnosis in these mothers as well. Further research is needed to understand and manage the unique consequences of postpartum hemorrhage in this vulnerable maternal population.

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Stroke survivors with severe mental illness: Are they at-risk for increased non-psychiatric hospitalizations?

Cited by 7 publications

References 47 publications

Social support, functional outcome and quality of life among stroke survivors in an urban area

Social support, functional outcome and quality of life among stroke survivors in an urban area

<p>Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke</p>

A retrospective analysis of complications associated with postpartum hemorrhage up to 1 year postpartum in mothers with and without a pre-existing mental health diagnosis

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