Post-stroke pathological crying: frequency and correlation to depression

While pathological crying has classically been described as a disturbance of the motor concomitants of emotional affect that is unrelated to mood, recent studies indicate that there may in fact be a correlation. We therefore undertook a study of post-stroke pathological crying in relation to mood score/depression and lesion site in an unselected stroke population the first year following stroke. The study population comprised 211 patients with first ever stroke (median age 69 years, range 25-80). The patients were included in the study within 7 days of the onset of stroke, and follow-up examinations were made at 1 month, 6 months and 1 year. Computerized tomography brain scans were obtained on Days 5-10. The frequency of pathological crying was 14% at 1 month, 10% at 6 months and 11% at 1 year. The overall 1 year incidence was 19%. Pathological crying correlated significantly to mood score and post-stroke depression (p < 0.005), as well as to lesion size (p < 0.05), Barthel Index (p < 0.05), Motricity Index (p < 0.005) and intellectual impairment (p < 0.05), but not to lesion location, sex, age, history of stroke or depression, predisposing disease or social distress before the stroke incident Post-stroke pathological crying was common and persistent in 11% of patients at 1 year and correlated strongly to mood score and post-stroke depression. The indication for treatment of pathological crying is therefore further strengthened.