Behavioral problems in stroke rehabilitation patients: A prospective pilot study

Thirty-two patients undergoing rehabilitation after stroke were prospectively evaluated in a pilot study to determine the frequency and significance of behavioral problems interfering with rehabilitation. Based on prior experience within the rehabilitation unit, we studied depression, as well as somnolence, irritability, anxiety, confusion, delusions, denial of deficit, impulsivity, inappropriate sexual behavior, and pain. Depression was present in 31% of patients, and other behavioral problems occurred in up to 41% of patients. Although the sample size was small, significant associations were noted between somnolence and left hemisphere infarct, between the number of behavioral problems and rehabilitation outcome, and between certain behavioral problems and neurologic variables. Behavioral problems other than depression are common after stroke, and such problems correlate with specific neurologic variables. Rehabilitation outcome can be hindered by these identified behavior problems.