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Poststroke psychosis: a systematic review.

Helle Stangeland1,2, Vasiliki Orgeta2, Vaughan Bell2

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Journal of Neurology, Neurosurgery, and Psychiatry
|January 15, 2018
PubMed
Summary
This summary is machine-generated.

Poststroke psychosis, affecting nearly 5% of stroke survivors, often presents with delusions and is linked to poor outcomes. Early intervention may be possible due to delayed onset, but treatment research is urgently needed.

Keywords:
hallucinationsneuropsychiatryschizophreniastroke

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Area of Science:

  • Neurology
  • Psychiatry
  • Systematic Review

Background:

  • Neuropsychiatric outcomes post-stroke significantly impair quality of life.
  • Poststroke psychosis lacks dedicated review despite its clinical importance.
  • This review addresses the clinical characteristics, prevalence, and outcomes of poststroke psychosis.

Purpose of the Study:

  • To systematically review poststroke psychosis, covering clinical features, prevalence, diagnosis, lesion location, treatments, risk factors, and outcomes.
  • To identify knowledge gaps and guide future research in this understudied area.

Main Methods:

  • Systematic review of CINAHL, MEDLINE, and PsychINFO databases (1975-2016).
  • Inclusion of 76 studies from 2442 references after independent selection and quality assessment.
  • Data extraction focused on clinical characteristics, prevalence, lesion location, treatments, risk factors, and outcomes.

Main Results:

  • Average age of onset 66.6 years; slightly more males affected.
  • Common diagnoses include delusional disorder, schizophrenia-like psychosis, and mood disorders with psychotic features.
  • Estimated prevalence of delusions at 4.67%, hallucinations at 5.05%; 12-year incidence at 6.7%.
  • Lesions often in the right hemisphere (frontal, temporal, parietal) and right caudate nucleus.
  • Associated with poor functional outcomes and high mortality; methodological limitations noted.

Conclusions:

  • Poststroke psychosis significantly increases stroke-related morbidity and mortality.
  • Delayed onset suggests potential for early intervention.
  • Urgent need for studies on antipsychotic safety and efficacy in poststroke psychosis patients.