1
|
Masuccio FG, Grange E, Di Giovanni R, Rolla M, Solaro CM. Post-Stroke Depression in Older Adults: An Overview. Drugs Aging 2024; 41:303-318. [PMID: 38396311 DOI: 10.1007/s40266-024-01104-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Detailed data on post-stroke depression (PSD) in older adults are limited in spite of the high vulnerability of this population to stroke. In fact, PSD prevalence in older adults ranges from 16.0 to 43.9%; however, timing and instruments of evaluation often differ significantly across all available studies. The etiology, genetic and inflammatory factors, as well as structural brain alterations, are claimed as part of a multifaceted mechanism of action in PSD onset. Thus, the aim of this narrative review was to further elaborate on the prevalence, etiology, diagnosis, consequences and treatment of PSD in older adults. The consequences of PSD in older adults may be devastating, including a poor functional outcome after rehabilitation and lower medication adherence. In addition, lower quality of life and reduced social participation, higher risk of new stroke, rehospitalization, and mortality have been reported. In this scenario, treating PSD represents a crucial step to prevent these complications. Both pharmacological and non-pharmacological therapies are currently available. The pharmacological treatment utilizes antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TAs) and new multimodal antidepressants (NMAs). Non-pharmacological therapies include psychological interventions and non-invasive brain stimulation techniques, while excluding drug administration. In the general population experiencing PSD, SSRIs (sertraline in particular) are the most prescribed, whereas the combination of antidepressants and psychotherapy is underused. Furthermore, about one-third of patients do not receive treatment for PSD. In regard to older adults with PSD, the possibility of more adverse effects or contraindications to antidepressant prescription due to comorbidities may limit the therapeutic window. Although drugs such as citalopram, escitalopram, sertraline, venlafaxine, and vortioxetine are usually well tolerated by older patients with PSD, the few randomized controlled trials (RCTs) specifically considering older adults with PSD have been conducted with fluoxetine, fluvoxamine, reboxetine, citalopram and nortriptyline, often with very small patient samples. Furthermore, data regarding the results of non-pharmacological therapies are scarce. High-quality RCTs recruiting large samples of older adults are needed in order to better manage PSD in this population. In addition, adequate screening and diagnosis instruments, with reliable timing of evaluation, should be applied.
Collapse
Affiliation(s)
- Fabio Giuseppe Masuccio
- Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone SNC, 13040, Moncrivello, VC, Italy
| | - Erica Grange
- Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone SNC, 13040, Moncrivello, VC, Italy
| | - Rachele Di Giovanni
- Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone SNC, 13040, Moncrivello, VC, Italy
| | - Martina Rolla
- Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone SNC, 13040, Moncrivello, VC, Italy
| | - Claudio Marcello Solaro
- Department of Rehabilitation, C.R.R.F. "Mons. L. Novarese", Loc. Trompone SNC, 13040, Moncrivello, VC, Italy.
| |
Collapse
|
2
|
Predictors of Post-Stroke Depression: A Retrospective Cohort Study. Brain Sci 2022; 12:brainsci12080993. [PMID: 35892434 PMCID: PMC9332855 DOI: 10.3390/brainsci12080993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/16/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
Abstract
Despite reports of a high incidence and various predictors of post-stroke depression (PSD), the underdiagnosis and undertreatment rates of PSD are still high. This study aimed to examine the incidence of depression in stroke patients and identify factors associated with PSD. This was a retrospective cohort study on ischemic stroke patients from the Geisinger Neuroscience Ischemic Stroke (GNSIS) registry. The following statistical analyses were performed to predict PSD in the studied population: a Kaplan−Meier estimator and a Cox proportional hazards model. A total of 5882 patients were included in the study. The median age at the time of an ischemic stroke was 72 years and 56% were males. A total of 294 patients were diagnosed with PSD within one year of a stroke. The cumulative incidence of depression was found to be 6.4% (95% CI 5.7−7.1%) at one year for the entire cohort. Women were found to have a higher risk of PSD than men (HR for women = 1.47, 95% CI 1.18−1.85, p = 0.001). A history of prior stroke (HR = 1.58, 95% CI 1.18−2.11, p = 0.002) and myocardial infarction (HR = 1.47, 95% CI 1.05−2.06, p = 0.025) were associated with PSD. Medicaid patients had a higher risk for PSD (HR = 2.16, 95% CI 1.5−3.12, p < 0.001) than those with commercial insurance or health maintenance organization plans. Our findings showed that women, patients with a history of prior stroke or myocardial infarction, and with Medicaid insurance were more likely to develop PSD. Through an observational study on the EHR data, we confirmed that chronic stress, including financial and health-related stress, irrespective of age, significantly increased the risk for PSD.
Collapse
|
3
|
Poststroke Anxiety at 1 Year After Rehabilitation. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
4
|
Svensson F, Much A, Exner C. Personality changes after acquired brain injury and their effects on rehabilitation outcomes. Neuropsychol Rehabil 2021; 33:305-324. [PMID: 34913399 DOI: 10.1080/09602011.2021.2011749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Acquired brain injury (ABI) is often associated with personality changes. Pre- as well as post-injury personality traits are related to rehabilitation outcomes. However, it largely remains unclear whether post-injury personality shows any associations with rehabilitation outcomes over and above pre-injury personality. Using a case-control design, this study investigated (1) personality changes after ABI from patients' and significant others' perspective, and (2) relations of pre- and post-ABI personality traits to rehabilitation outcomes in the short- and long-term. 40 patients with ABI (85% stroke, 15% traumatic brain injury), 46 healthy controls and their significant others participated. Personality was assessed with NEO-FFI, rehabilitation outcomes (activities, participation, depression) were measured at two and ten months after ABI. Patient-ratings indicated decreases in extraversion and a trend towards reduced conscientiousness. Significant others reported increases in patients' neuroticism. Pre- as well as post-injury personality traits were associated with depression and activities at both short- and long-term timepoints after ABI. The association was strongest for long-term depressive symptoms where personality trait variables accounted for 49% of variance (Radjusted2). Our results confirm that ABI patients and significant others perceive personality changes, albeit in different dimensions. Pre- and post-ABI personality traits showed associations with rehabilitation outcomes, especially with emotional adjustment after the injury.
Collapse
Affiliation(s)
- Frederike Svensson
- Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Anne Much
- Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Cornelia Exner
- Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| |
Collapse
|
5
|
Yang J, Yu Y, Wang W, Qiu J. Atypical neural activation associated with implicit negative emotional facial processing in fMRI tasks in individuals with neuroticism personality traits. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01486-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
6
|
Abstract
Neuropsychiatric disturbances represent a common and uniquely challenging consequence of stroke. These disorders arise at the intersection of lesion-related brain dysfunction and psychological distress related to the event and its aftermath, making it difficult to identify what symptom is a direct physiological consequence of the stroke. Depression, anxiety, fatigue, apathy, emotionalism, and anger are the most common of these syndromes, and posttraumatic stress disorder related to the stroke event has become increasingly recognized as a relevant entity. Mania, obsessive-compulsive disorder, and psychosis are less commonly encountered but potentially highly debilitating conditions that may be underrecognized. Early identification and treatment may mitigate functional impairment and improve quality of life. Evidence-based guidelines from the general population are often relied upon to guide treatment. Further research is needed to understand and tailor treatment of these disorders in the poststroke population.
Collapse
Affiliation(s)
- Katlyn Nemani
- Departments of Neurology and Psychiatry, NYU Langone Health, New York, New York
| | - Lindsey Gurin
- Departments of Neurology, Psychiatry, and Rehabilitation Medicine, NYU Langone Health, New York, New York
| |
Collapse
|
7
|
Klingbeil J, Brandt ML, Wawrzyniak M, Stockert A, Schneider HR, Baum P, Hoffmann KT, Saur D. Association of Lesion Location and Depressive Symptoms Poststroke. Stroke 2021; 52:830-837. [PMID: 33504189 DOI: 10.1161/strokeaha.120.031889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Poststroke depression is a common stroke sequel, yet its neurobiological substrates are still unclear. We sought to determine whether specific lesion locations are associated with depressive symptoms after stroke. METHODS In a prospective study, 270 patients with first ever stroke were repeatedly tested with the depression subscale of the Hospital Anxiety and Depression Scale within the first 4 weeks and 6 months after stroke. Voxel-based lesion behavior mapping based on clinical imaging was performed to test for associations between symptoms of depression and lesion locations. RESULTS Frequency of poststroke depression (Hospital Anxiety and Depression Scale-D score >7) after 6 months was 19.6%. Higher Hospital Anxiety and Depression Scale-D scores for depression within the first 4 weeks were the only independent predictor for poststroke depression after 6 months in a multiple logistic regression also including age, sex, lesion volume, stroke severity, Barthel-Index, and the anxiety subscale of the Hospital Anxiety and Depression Scale. Nonparametric permutation-test based voxel-based lesion behavior mapping identified a cluster of voxels mostly within the left ventrolateral prefrontal cortex where lesions were significantly associated with more depressive symptoms after 6 months. No such association was observed within the right hemisphere despite better lesion coverage. CONCLUSIONS Lesions in the left ventrolateral prefrontal cortex increase the risk of depressive symptoms 6 months poststroke. Lesions within the right hemisphere are unrelated to depressive symptoms. Recognition of left frontal lesions as a risk factor should help in the early diagnosis of poststroke depression through better risk stratification. The results are in line with evidence from functional imaging and noninvasive brain stimulation in patients without focal brain damage indicating that dysfunction in the left lateral prefrontal cortex contributes to depressive disorders.
Collapse
Affiliation(s)
- Julian Klingbeil
- Department of Neurology, University of Leipzig Medical Center, Germany
| | | | - Max Wawrzyniak
- Department of Neurology, University of Leipzig Medical Center, Germany
| | - Anika Stockert
- Department of Neurology, University of Leipzig Medical Center, Germany
| | | | - Petra Baum
- Department of Neurology, University of Leipzig Medical Center, Germany
| | | | - Dorothee Saur
- Department of Neurology, University of Leipzig Medical Center, Germany
| |
Collapse
|
8
|
Influence of an Aquatic Therapy Program on Perceived Pain, Stress, and Quality of Life in Chronic Stroke Patients: A Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134796. [PMID: 32635281 PMCID: PMC7369960 DOI: 10.3390/ijerph17134796] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/20/2020] [Accepted: 07/01/2020] [Indexed: 12/19/2022]
Abstract
Pain and depressive states may have a negative impact on the quality of life of individuals with stroke. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression, and quality of life in a sample of people with stroke. Forty-five participants received physiotherapy treatment on dry land (control group), an experimental group received aquatic Ai Chi therapy, and a combined therapy group received alternating sessions of physiotherapy on dry land and aquatic Ai Chi therapy. The Visual Analog Scale (VAS) scale for pain, the resilience scale, and the SF-36 quality of life scale were used as outcome measures. Statistically significant differences were found in the experimental group and the combined intervention group for post treatment pain and resilience (p < 0.001). Concerning the SF-36, statistically significant changes (p < 0.01) were found in the experimental group and the combined therapy group for all items except general health, vitality, and social function, where no between group differences were observed (p = 0.001). In conclusion, physical exercise performed in water has positive effects on several factors that contribute towards improving the mood and quality of life of people with acquired brain injury.
Collapse
|
9
|
Han Z, Wang Y, Qi L, Wang J, Wong J, Chen J, Luo X, Wang QM. Differential Association of Serum BDNF With Poststroke Depression and Poststroke Anxiety. Arch Phys Med Rehabil 2020; 101:1355-1366. [PMID: 32416148 DOI: 10.1016/j.apmr.2020.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/08/2020] [Accepted: 04/19/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the correlation between brain-derived neurotrophic factor (BDNF) and risk factors, as well as functional outcome in poststroke depression (PSD) or poststroke anxiety (PSA). DESIGN Cohort study. SETTING Stroke patients admitted to an urban rehabilitation hospital. PARTICIPANTS Stroke patients (N=162) without any previous history of depression and anxiety. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Sociodemographic information and comorbidities were recorded during hospital admission. Functional outcomes were assessed using FIM scores at time of admission and discharge. The influence of various factors such as BDNF and patient characteristics on functional outcome was investigated. Single-factor effect was examined using simple logistic regression, as was multi-factor effect using multiple logistic regression. The goodness-of-fit of those regression models was evaluated by the integrated area under ROC curve. RESULTS PSD was diagnosed in 61 (37.7%) patients, and PSA was diagnosed in 40 (24.7%). Multiple logistic analysis showed that BDNF, divorce or separation, and history of smoking were significantly associated with the occurrence of PSD but not with the occurrence of PSA. The model combining low BDNF level and divorce or separation improved the prediction for PSD. Among the variables analyzed for prediction of functional outcome, serum BDNF had a minimum correlation with motor FIM scores in PSD but no significant correlation with motor FIM scores in PSA. CONCLUSIONS BDNF is a valuable prediction for the occurrence of PSD but not for PSA. More strikingly, ischemic stroke patients who are divorced or separated with low serum BDNF have a much higher risk for PSD. BDNF has a minimum correlation with motor function outcome in PSD but no significant correlation with motor outcome in PSA.
Collapse
Affiliation(s)
- Zhenxiang Han
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China
| | - Yao Wang
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, Guangdong, P.R. China
| | - Lili Qi
- Department of Emergency, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM, Shanghai, P.R. China
| | - Jiening Wang
- Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China
| | - John Wong
- School of Nursing and Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA
| | - Jiaohua Chen
- Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China
| | - Xun Luo
- Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, Guangdong, P.R. China; Kerry Rehabilitation Medicine Research Institute, Shenzhen, Guangdong, P.R. China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.
| |
Collapse
|
10
|
Individual differences in neuroticism personality trait in emotion regulation. J Affect Disord 2020; 265:468-474. [PMID: 32090774 DOI: 10.1016/j.jad.2020.01.086] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Higher neuroticism personality trait individuals have more negative mood states, more sensitive to negative information, and higher risk of mental illness. Good emotion regulation ability play an important role in healthy psychological, social and physical outcomes. Previous studies have suggested that higher neuroticism individuals have a diminished ability to regulate emotion regulation. Up to now, few studies investigate the neural basis between neuroticism and emotion regulation. METHOD In present study, we want to explore the neuroticism and the activity of some brain regions and functional amygdala connectivity (psycho-physiological interaction [PPI]) in a cognitive reappraisal task. Thus, 160 healthy young participants were scanned during a cognitive reappraisal task. RESULTS The results revealed that neuroticism scores showed a significant negative association with the activity of the dorsomedial prefrontal cortex (dmPFC), inferior frontal cortex and middle frontal cortex in regulation of negative emotion. PPI analyses revealed that neuroticism scores were negatively associated with amygdala-dmPFC connectivity in regulation of negative emotion. LIMITATION Only cognitive reappraisal were investigated in this study. Other emotion regulation strategies such as expressive suppression need to be explored in the future study. CONCLUSION These results may suggest that highly neurotic participants display diminished cognitive reappraisal and diminished control function of the dmPFC over the amygdala in regulation of negative emotion.
Collapse
|
11
|
Knapp P, Dunn-Roberts A, Sahib N, Cook L, Astin F, Kontou E, Thomas SA. Frequency of anxiety after stroke: An updated systematic review and meta-analysis of observational studies. Int J Stroke 2020; 15:244-255. [PMID: 31980004 DOI: 10.1177/1747493019896958] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Anxiety is a common and distressing problem after stroke. AIMS To undertake an updated systematic review and meta-analysis of observational studies of anxiety after stroke and integrate the findings with those reported previously. SUMMARY OF REVIEW Multiple databases were searched in May 2018 and 53 new studies were included following dual independent sifting and data extraction. These were combined with 44 previous studies to form a combined data set of 97 studies, comprising 22,262 participants. Studies using interview methods were of higher quality. Rates of anxiety by interview were 18.7% (95% confidence interval 12.5, 24.9%) and 24.2% (95% confidence interval 21.5, 26.9%) by rating scale. Rates of anxiety did not lower meaningfully up to 24 months after stroke. Eight different anxiety subtypes were also reported. CONCLUSIONS This review confirms that anxiety occurs in around one in four patients (by rating scale) and one in five patients (by interview). More research on anxiety subtypes is needed for an informed understanding of its effects and the development of interventions.
Collapse
Affiliation(s)
- Peter Knapp
- Department of Health Sciences, University of York, York, UK
| | | | - Nimah Sahib
- Hull York Medical School, Kingston upon Hull, UK
| | - Liz Cook
- Department of Health Sciences, University of York, York, UK
| | | | - Eirini Kontou
- Medical School Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - Shirley A Thomas
- Medical School Queens Medical Centre, University of Nottingham, Nottingham, UK
| |
Collapse
|
12
|
Lee EH, Kim JW, Kang HJ, Kim SW, Kim JT, Park MS, Cho KH, Kim JM. Association between Anxiety and Functional Outcomes in Patients with Stroke: A 1-Year Longitudinal Study. Psychiatry Investig 2019; 16:919-925. [PMID: 31698556 PMCID: PMC6933133 DOI: 10.30773/pi.2019.0188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/01/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Anxiety is one of the most common complications in patients with stroke, but studies on its relationship to functional outcomes are limited and controversial. We investigated the association between post-stroke anxiety (PSA) and a 1-year trajectory of functional outcome. METHODS A total of 423 patients were recruited within 2 weeks after a stroke (acute phase) during hospitalization. Of them, 306 (72.3%) completed follow-up examinations 1 year thereafter (chronic phase). Anxiety was evaluated using the Hospital Anxiety and Depression Scale-Anxiety subscale, and functional outcomes were measured using the National Institutes of Health Stroke Scale for stroke severity, the Barthel Index for activities of daily living (ADL), and the Mini-Mental State Examination for cognitive function at 2 weeks and 1 year. A range of demographic and clinical covariates were considered. The cross-sectional and longitudinal associations between PSA and functional outcomes were investigated. RESULTS PSA at the acute phase was not associated with functional outcomes at the cross-sectional point, but predicted worsening of outcome on stroke severity and ADL 1 year after stroke. PSA at the chronic phase was cross-sectionally associated with poor functional outcomes in all three measures. All associations were independent of potential covariates. CONCLUSION Screening for anxiety is recommended even during the acute phase of stroke, considering its independent detrimental effect on functional prognosis. Screening for anxiety during the chronic phase is also encouraged, as this may reflect the functional status of stroke.
Collapse
Affiliation(s)
- Eun-Hye Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Man-Seok Park
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ki-Hyun Cho
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| |
Collapse
|
13
|
Kang HJ, Kim KO, Kim JW, Kim SW, Park MS, Kim HR, Shin MG, Cho KH, Kim JM. A longitudinal study of the associations of BDNF genotype and methylation with poststroke anxiety. Int J Geriatr Psychiatry 2019; 34:1706-1714. [PMID: 31368178 DOI: 10.1002/gps.5185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/28/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although the precise etiology of poststroke anxiety (PSA) has yet to be fully elucidated, it is known that brain-derived neurotrophic factor (BDNF) is important for neural plasticity and long-term potentiation, associated with the pathophysiology of anxiety. The expression of BDNF is regulated by epigenetic and genetic profiles. Thus, we investigated the association between BDNF methylation status and PSA at 2 weeks and 1 year after stroke while accounting for interactions with the BDNF Val66Met polymorphism. METHODS The baseline sample comprised 286 patients who were assessed at 2 weeks after stroke; of these patients, 222 (78%) were followed up with at 1 year after stroke. The presence of PSA was determined using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS), and the effects of BDNF methylation status and polymorphisms on PSA status were assessed with multivariate logistic regression models. RESULTS The prevalence of PSA was slightly lower (27 [9.4%]) at baseline, and 35 (15.8%) patients were identified as having PSA at the 1-year follow-up. Stroke patients with a higher average methylation status were more likely to have PSA at 1 year. The BDNF Val66Met polymorphism was not independently associated with PSA during either the acute or chronic phase after stroke, but there was a significant interactive effect between BDNF methylation and genotype on PSA at 2 weeks. CONCLUSIONS In this study, BDNF methylation in combination with the met/met BDNF polymorphism (Val66Met polymorphism) was associated with PSA. These findings may help identify patients at higher risk for PSA.
Collapse
Affiliation(s)
- Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kyu-On Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Man-Seok Park
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
| | - Hye-Ran Kim
- College of Korean Medicine, Dongshin University, Korea
| | - Myung-Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ki-Hyun Cho
- Department of Neurology, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| |
Collapse
|
14
|
Taylor-Rowan M, Momoh O, Ayerbe L, Evans JJ, Stott DJ, Quinn TJ. Prevalence of pre-stroke depression and its association with post-stroke depression: a systematic review and meta-analysis. Psychol Med 2019; 49:685-696. [PMID: 30107864 DOI: 10.1017/s0033291718002003] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Depression is a common post-stroke complication. Pre-stroke depression may be an important contributor, however the epidemiology of pre-stroke depression is poorly understood. Using systematic review and meta-analysis, we described the prevalence of pre-stroke depression and its association with post-stroke depression. METHODS We searched multiple cross-disciplinary databases from inception to July 2017 and extracted data on the prevalence of pre-stroke depression and its association with post-stroke depression. We assessed the risk of bias (RoB) using validated tools. We described summary estimates of prevalence and summary odds ratio (OR) for association with post-stroke depression, using random-effects models. We performed subgroup analysis describing the effect of depression assessment method. We used a funnel plot to describe potential publication bias. The strength of evidence presented in this review was summarised via 'GRADE'. RESULTS Of 11 884 studies identified, 29 were included (total participants n = 164 993). Pre-stroke depression pooled prevalence was 11.6% [95% confidence interval (CI) 9.2-14.7]; range: 0.4-24% (I2 95.8). Prevalence of pre-stroke depression varied by assessment method (p = 0.02) with clinical interview suggesting greater pre-stroke depression prevalence (~17%) than case-note review (9%) or self-report (11%). Pre-stroke depression was associated with increased odds of post-stroke depression; summary OR 3.0 (95% CI 2.3-4.0). All studies were judged to be at RoB: 59% of included studies had an uncertain RoB in stroke assessment; 83% had high or uncertain RoB for pre-stroke depression assessment. Funnel plot indicated no risk of publication bias. The strength of evidence based on GRADE was 'very low'. CONCLUSIONS One in six stroke patients have had pre-stroke depression. Reported rates may be routinely underestimated due to limitations around assessment. Pre-stroke depression significantly increases odds of post-stroke depression.Protocol identifierPROSPERO identifier: CRD42017065544.
Collapse
Affiliation(s)
- Martin Taylor-Rowan
- Institute of Cardiovascular and Medical Sciences,University of Glasgow,Glasgow,UK
| | - Oyiza Momoh
- Institute of Cardiovascular and Medical Sciences,University of Glasgow,Glasgow,UK
| | - Luis Ayerbe
- Centre of Primary Care and Public Health,Queen Mary University of London,London,UK
| | - Jonathan J Evans
- Institute of Health and Wellbeing,University of Glasgow,Glasgow,UK
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences,University of Glasgow,Glasgow,UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences,University of Glasgow,Glasgow,UK
| |
Collapse
|
15
|
Van Heugten C, Meuleman S, Hellebrekers D, Kruitwagen-van Reenen E, Visser-Meily J. Participation and the Role of Neuropsychological Functioning in Myotonic Dystrophy Type 1. J Neuromuscul Dis 2018; 5:205-214. [PMID: 29865086 DOI: 10.3233/jnd-170246] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Myotonic Dystrophy type 1 (DM1) is primarily a neuromuscular disease but can also have neuropsychological consequences (i.e.cognitive, emotional and behavioural) which can influence daily living and societal participation. Not much is known about the level of participation of DM1 patients and their relatives and the factors influencing participation. This information can guide the development of rehabilitation programs and identify those at risk of long-term participation problems. OBJECTIVE To investigate the level of participation of DM1 patients and their partners and the determinants. METHODS Cross-sectional study using the Utrecht Scale for Evaluation of Rehabilitation-Participation. Determinants were demographic, disease related, and neuropsychological characteristics. Spearman correlations and backward multiple regression analyses were performed. RESULTS Of the 66 DM1 participants, 54% reported severe fatigue and 47% apathy. Experienced participation restrictions were most prevalent in housekeeping (74%), sports (68%) and outdoor activities (55%). Participants were relatively satisfied with their level of participation, but dissatisfaction occurred mostly in housekeeping (58%), outdoor activities (55%), and sports (54%). Age and apathy were significant predictors of frequency of (R2 = 10.4) and restrictions in participation in the multivariate model (R2 = 14.4). Emotional functioning was the only significant predictor of satisfaction with participation (R2 = 23.8). CONCLUSIONS A considerable number of DM1 patients have Central Nervous System-related problems such as fatigue and apathy in addition to neuromuscular restrictions. Risk factors for lower participation are age, apathy, and emotional problems. Physical as well as neuropsychological rehabilitation programs are recommended.
Collapse
Affiliation(s)
- Caroline Van Heugten
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Susan Meuleman
- Merem Rehabilitation Center De Trappenberg, Almere, The Netherlands
| | - Danique Hellebrekers
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Esther Kruitwagen-van Reenen
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Johanna Visser-Meily
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| |
Collapse
|
16
|
|
17
|
Fresson M, Dardenne B, Meulemans T. Influence of diagnosis threat and illness cognitions on the cognitive performance of people with acquired brain injury. Neuropsychol Rehabil 2018; 29:1637-1654. [DOI: 10.1080/09602011.2018.1439756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Megan Fresson
- Psychology and Neurosciences of Cognition Unit, University of Liège (Belgium), Liège, Belgium
| | - Benoit Dardenne
- Psychology and Neurosciences of Cognition Unit, University of Liège (Belgium), Liège, Belgium
| | - Thierry Meulemans
- Psychology and Neurosciences of Cognition Unit, University of Liège (Belgium), Liège, Belgium
| |
Collapse
|
18
|
Dwan T, Ownsworth T. The Big Five personality factors and psychological well-being following stroke: a systematic review. Disabil Rehabil 2017; 41:1119-1130. [PMID: 29272953 DOI: 10.1080/09638288.2017.1419382] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To identify and appraise studies investigating the relationship between the Big Five personality factors and psychological well-being following stroke and evidence for personality change. METHODS Systematic searches of six databases (PsychINFO, CINAHL, Ovid Medline, Cochrane, PubMed, and Web of Science) were conducted from inception to June 2017. Studies involving adult stroke samples that employed a validated measure of at least one of the Big Five personality factors were included. Two reviewers independently assessed the eligibility and methodological quality of studies. RESULTS Eleven studies were identified that assessed associations between personality and psychological well-being after stroke (nine studies) or post-stroke personality change (two studies). A consistent finding was that higher neuroticism was significantly related to poorer psychological well-being. The evidence for the other Big Five factors was mixed. In terms of personality change, two cross-sectional studies reported high rates of elevated neuroticism (38-48%) and low extraversion (33-40%) relative to normative data. Different questionnaires and approaches to measuring personality (i.e., self vs. informant ratings, premorbid personality vs. current personality) complicated comparisons between studies. CONCLUSIONS People high on neuroticism are at increased risk of poor psychological well-being after stroke. Prospective longitudinal studies are needed to address the limited research on post-stroke personality change. Implications for rehabilitation High neuroticism is associated with poorer psychological well-being after stroke. Assessing personality characteristics early after stroke may help to identify those at risk of poor psychological outcomes.
Collapse
Affiliation(s)
- Toni Dwan
- a School of Applied Psychology and Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | - Tamara Ownsworth
- a School of Applied Psychology and Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| |
Collapse
|
19
|
Arwert H, Schut S, Boiten J, Vliet Vlieland T, Meesters J. Patient reported outcomes of hand function three years after stroke. Top Stroke Rehabil 2017; 25:13-19. [PMID: 29025365 DOI: 10.1080/10749357.2017.1385232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To comprehensively describe hand function and associated factors among stroke survivors by means of the Michigan Hand Outcomes Questionnaire (MHQ; 6 domains; score 0-100, worst-best). METHODS In this cross-sectional study, stroke patients were invited to complete a set of questionnaires on hand function, socio-demographic characteristics, mental functioning, daily activities, quality of life, and caregiver strain. Stroke characteristics were collected retrospectively from medical records. Multiple linear regression analysis adjusted for age, sex, and duration of follow-up was used to identify factors associated with MHQ score. RESULTS 207 out of 576 eligible patients responded (36%); mean age 63.8 years (SD14.2), 125 males (60.4%). Mean time since stroke was 36.3 months (SD9.9). In 85% of the patients, the MHQ Total score was less than 100 points (median 79.9, IQR 63.0-95.8). The median scores of the domains were: overall hand function 75.0, daily activities 90.5, work 85.0, pain 100, appearance 93.8, and satisfaction with hand function 83.3. A lower MHQ Total score was significantly associated with a lower Barthel Index at hospital discharge, a lower level of education, a supratentorial stroke and with unfavorable outcomes regarding physical and mental functioning, quality of life, and caregiver strain. CONCLUSION Patients can perceive limitations on several domains with respect to hand function 2-5 years after stroke. Problems related to the appearance of the hand and satisfaction with hand function can be relevant and should be considered accordingly. Persistent hand problems after stroke are related to a more severe, supratentorial stroke in lower educated patients.
Collapse
Affiliation(s)
- Henk Arwert
- a Sophia Rehabilitation Center , The Hague , The Netherlands.,b Department of Rehabilitation , Haaglanden Medical Center , The Hague , The Netherlands
| | - Selma Schut
- a Sophia Rehabilitation Center , The Hague , The Netherlands
| | - Jelis Boiten
- c Department of Neurology , Haaglanden Medical Center , The Hague , The Netherlands
| | - Thea Vliet Vlieland
- a Sophia Rehabilitation Center , The Hague , The Netherlands.,d Department of Orthopedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands.,e Rijnland Rehabilitation Center , Leiden , The Netherlands
| | - Jorit Meesters
- a Sophia Rehabilitation Center , The Hague , The Netherlands.,d Department of Orthopedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands
| |
Collapse
|
20
|
Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, Xiong Y, Deng J, Liu A. Comorbidity of post-traumatic stress disorder and anxiety in flood survivors: Prevalence and shared risk factors. Medicine (Baltimore) 2017; 96:e7994. [PMID: 28885358 PMCID: PMC6393105 DOI: 10.1097/md.0000000000007994] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) and anxiety are both prevalent in trauma-related populations. However, comorbidity of these 2 psychiatric disorders has not been investigated in flood survivors. This study aimed to estimate the extent to which PTSD and anxiety co-occur in flood survivors, and identify shared risk factors for PTSD only and comorbidity of PTSD and anxiety.Individuals who experienced Dongting Lake flood in 1998 were enrolled in this study using stratified and systematic random sampling method. Information on social support, personality traits, PTSD, and anxiety was collected using self-report questionnaires. The intensity of exposure to the flood was measured by some questions. Logistic regression analyses were used to identify factors associated with PTSD only and comorbidity of PTSD and anxiety.In all, 325 participants were enrolled in this study. The prevalence of PTSD, anxiety, and comorbidity of PTSD and anxiety among survivors of the 1998 Dongting Lake flood at 17-year follow-up was 9.54%, 9.23%, and 6.15%, respectively. Furthermore, 64.52% of those with PTSD had anxiety and 66.67% of those with anxiety had PTSD. Loss of relative, injury of body, damage of house, and emotional instability were shared risk factors for PTSD only and comorbidity of PTSD and anxiety, in comparison with neither PTSD nor anxiety.Post-traumatic stress disorder only and comorbidity of PTSD and anxiety are prevalent in flood survivors, and are both related to the intensity of exposure to the flood and personality traits, indicating that integrated intervention strategies of PTSD and anxiety for flood survivors are needed.
Collapse
Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
- Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Zhiwei Lai
- Hunan Provincial Center for Disease Control and Prevention, Hunan, China
| | - Xin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Yuan Xiong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| |
Collapse
|
21
|
Vansimaeys C, Zuber M, Pitrat B, Join-Lambert C, Tamazyan R, Farhat W, Bungener C. Combining Standard Conventional Measures and Ecological Momentary Assessment of Depression, Anxiety and Coping Using Smartphone Application in Minor Stroke Population: A Longitudinal Study Protocol. Front Psychol 2017; 8:1172. [PMID: 28747895 PMCID: PMC5506189 DOI: 10.3389/fpsyg.2017.01172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/27/2017] [Indexed: 12/19/2022] Open
Abstract
Context: Stroke has several consequences on survivors’ daily life even for those who experience short-lasting neurological symptoms with no functional disability. Depression and anxiety are common psychological disorders occurring after a stroke. They affect long-term outcomes and quality of life but they are difficult to diagnose because of the neurobiological consequences of brain lesions. Current research priority is given to the improvement of the detection and prevention of those post-stroke psychological disorders. Although previous studies have brought promising perspectives, their designs based on retrospective tools involve some limits regarding their ecological validity. Ecological Momentary Assessment (EMA) is an alternative to conventional instruments that could be a key in research for understanding processes that underlined post-stroke depression and anxiety onset. We aim to evaluate the feasibility and validity of anxiety, depression and coping EMA for minor stroke patients. Methods: Patients hospitalized in an Intensive Neuro-vascular Care Unit between April 2016 and January 2017 for a minor stroke is involved in a study based on an EMA methodology. We use a smartphone application in order to assess anxiety and depression symptoms and coping strategies four times a day during 1 week at three different times after stroke (hospital discharge, 2 and 4 months). Participants’ self-reports and clinician-rates of anxiety, depression and coping are collected simultaneously using conventional and standard instruments. Feasibility of the EMA method will be assessed considering the participation and compliance rate. Validity will be the assessed by comparing EMA and conventional self-report and clinician-rated measures. Discussion: We expect this study to contribute to the development of EMA using smartphone in minor stroke population. EMA method offers promising research perspective in the assessment and understanding of post-stroke psychological disorders. The development of EMA in stroke population could lead to clinical implications such as remotely psychological follow-ups during early supported discharge. Trial registration: European Clinical Trials Database Number 2014-A01937-40
Collapse
Affiliation(s)
- Camille Vansimaeys
- Laboratory of Psychopathology and Health Processes, Psychology Institute, Université Paris Descartes-Sorbonne Paris CitéParis, France
| | - Mathieu Zuber
- Neurology and Neurovascular Department, Saint Joseph Hospital Group, Université Paris Descartes-Sorbonne Paris CitéParis, France
| | - Benjamin Pitrat
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique-Hôpitaux de ParisParis, France
| | - Claire Join-Lambert
- Neurology and Neurovascular Department, Saint Joseph Hospital Group, Université Paris Descartes-Sorbonne Paris CitéParis, France
| | - Ruben Tamazyan
- Neurology and Neurovascular Department, Saint Joseph Hospital Group, Université Paris Descartes-Sorbonne Paris CitéParis, France
| | - Wassim Farhat
- Neurology and Neurovascular Department, Saint Joseph Hospital Group, Université Paris Descartes-Sorbonne Paris CitéParis, France
| | - Catherine Bungener
- Laboratory of Psychopathology and Health Processes, Psychology Institute, Université Paris Descartes-Sorbonne Paris CitéParis, France
| |
Collapse
|
22
|
Shi Y, Yang D, Zeng Y, Wu W. Risk Factors for Post-stroke Depression: A Meta-analysis. Front Aging Neurosci 2017; 9:218. [PMID: 28744213 PMCID: PMC5504146 DOI: 10.3389/fnagi.2017.00218] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/23/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Stroke not only impacts patients physically but also economically. Post-stroke depression (PSD), as a common complication of stroke, always obstructs the process of stroke rehabilitation. Accordingly, defining the risk factors associated with PSD has extraordinary importance. Although there have been many studies investigating the risk factors for PSD, the results are inconsistent. Objectives: The objectives of this study were to identify the risk factors for PSD by evidence-based medicine. Data sources: A systematic and comprehensive database search was performed of PubMed, Medline, CENTRAL, EMBASE.com, the Cochrane library and Web of Science for Literature, covering publications from January 1, 1998 to November 19, 2016. Study Selection: Studies on risk factors for PSD were identified, according to inclusion and exclusion criteria. The risk of bias tool, described in the Cochrane Handbook version 5.1.0, was used to assess the quality of each study. Meta-analysis was performed using RevMan 5.3 software. Results: Thirty-six studies were included for review. A history of mental illness was the highest ranking modifiable risk factor; other risk factors for PSD were female gender, age (<70 years), neuroticism, family history, severity of stroke, and level of handicap. Social support was a protective factor for PSD. Conclusion: There are many factors that have effects on PSD. The severity of stroke is an important factor in the occurrence of PSD. Mental history is a possible predictor of PSD. Prevention of PSD requires social and family participation.
Collapse
Affiliation(s)
- Yu Shi
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical UniversityGuangzhou, China
| | - Dongdong Yang
- Department of Neurology, Zhengzhou People's HospitalZhengzhou, China
| | - Yanyan Zeng
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical UniversityGuangzhou, China
| | - Wen Wu
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical UniversityGuangzhou, China
| |
Collapse
|
23
|
The Role of Short Term Psychological and Somatic Anxiety in the Prediction of Long Term Anxiety of Early Hospital Discharged Patients with Complete Functional Recovery after a Mild Stroke. JOURNAL OF EUROPEAN PSYCHOLOGY STUDENTS 2017. [DOI: 10.5334/jeps.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
24
|
Huang HC, Chang CH, Hu CJ, Shyu ML, Chen CI, Huang CS, Tsai HT, Chang HJ. Time-Varying Effects of Psychological Distress on the Functional Recovery of Stroke Patients. Arch Phys Med Rehabil 2017; 98:722-729. [DOI: 10.1016/j.apmr.2016.09.120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 11/25/2022]
|
25
|
Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, Liu A. Long-term psychological outcomes of flood survivors of hard-hit areas of the 1998 Dongting Lake flood in China: Prevalence and risk factors. PLoS One 2017; 12:e0171557. [PMID: 28170427 PMCID: PMC5295691 DOI: 10.1371/journal.pone.0171557] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 01/23/2017] [Indexed: 12/11/2022] Open
Abstract
Background Although numerous studies have indicated that exposure to natural disasters may increase survivors’ risk of post-traumatic stress disorder (PTSD) and anxiety, studies focusing on the long-term psychological outcomes of flood survivors are limited. Thus, this study aimed to estimate the prevalence of PTSD and anxiety among flood survivors 17 years after the 1998 Dongting Lake flood and to identify the risk factors for PTSD and anxiety. Methods This cross-sectional study was conducted in December 2015, 17 years after the 1998 Dongting Lake flood. Survivors in hard-hit areas of the flood disaster were enrolled in this study using a stratified, systematic random sampling method. Well qualified investigators conducted face-to-face interviews with participants using the PTSD Checklist-Civilian version, the Zung Self-Rating Anxiety Scale, the Chinese version of the Social Support Rating Scale and the Revised Eysenck Personality Questionnaire-Short Scale for Chinese to assess PTSD, anxiety, social support and personality traits, respectively. Logistic regression analyses were used to identify factors associated with PTSD and anxiety. Results A total of 325 participants were recruited in this study, and the prevalence of PTSD and anxiety was 9.5% and 9.2%, respectively. Multivariable logistic regression analyses indicated that female sex, experiencing at least three flood-related stressors, having a low level of social support, and having the trait of emotional instability were risk factors for long-term adverse psychological outcomes among flood survivors after the disaster. Conclusions PTSD and anxiety were common long-term adverse psychological outcomes among flood survivors. Early and effective psychological interventions for flood survivors are needed to prevent the development of PTSD and anxiety in the long run after a flood, especially for individuals who are female, experience at least three flood-related stressors, have a low level of social support and have the trait of emotional instability.
Collapse
Affiliation(s)
- Wenjie Dai
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Atipatsa C. Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Mathematics, Mzuzu University, Mzuzu, Malawi
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jieru Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Zhiwei Lai
- Immune Planning Division, Hunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
- * E-mail:
| |
Collapse
|