[An exploratory study of the relation between cerebrovascular accidents and personality structures]

In recent years the psychological aspects linked with cerebrovascular accidents (CVA) have often been studied from the consequences they generate. AIMS. To explore the type of relation that exists between CVA and personality structures as a premorbid risk factor (RF), including their possible relation to the characteristics of brain injury.

97 patients who were admitted to hospital consecutively for a first CVA were evaluated and a follow up was carried out on 38 of them. In the acute episode and in the follow up we collected data about their medical history, from studies using neuroimaging and from a semi structured interview which was administered to the patient or a relative.

A predominance of personality traits similar to those of type A personality was found. These traits are grouped in the following structures: moody (depressive), over adapted, logical (obsessive) and suspicious distrustful (paranoid), with a clear predominance of traits of low tolerance to frustration, irritability, lack of care for or abuse of the body, exigency, perfectionism, rigidity, magical thought and illness understood as being weakness or bad luck and health as a must be . Depressive states, with or without anxiety, were also found with significant frequency. None of these states or reactions was associated to any kind of brain injury in particular, both in their type and in their topography.

Results show a tendency that is similar to studies with heart patients and with patients with CVA that have already been published and can be grouped under the denomination of type A personality . Therefore, type A personality can be considered as a factor linked to vascular diseases involving at least two territories (heart and brain). It remains to be ascertained whether the brain territory is only a RF or a necessary or sufficient condition. Psychological evaluation of the subjects at risk or already affected by a CVA is relevant and to be taken into account in both prevention and therapy and rehabilitation.