Long-Term Changes in Post-Stroke Depression, Emotional Incontinence, and Anger

Area of Science:

• Neurology
• Psychiatry
• Clinical Psychology

Background:

• Long-term changes in post-stroke depression (PSD), post-stroke emotional incontinence (PSEI), and post-stroke anger (PSA) are understudied.
• Understanding these long-term emotional and behavioral sequelae is crucial for comprehensive stroke patient care.

Purpose of the Study:

• To investigate the long-term changes in PSD, PSEI, and PSA after stroke.
• To identify factors associated with these long-term changes, including social support and physical disability.

Main Methods:

• Sub-study of the EMOTION randomized trial involving 222 stroke patients.
• Long-term assessment (median 59.5 months) using validated scales: MADRS for PSD, modified Kim's criteria for PSEI, Spielberger trait anger scale for PSA.
• Evaluation of social support (ESSI) and functional status (mRS) to determine associated factors.

Main Results:

• Long-term, PSD prevalence increased (35.6% to 44.6%), while PSEI prevalence decreased (11.7% to 6.3%).
• Mean anger scores significantly decreased (21.62 to 16.24), but mean MADRS scores for PSD increased (6.16 to 8.67).
• Low social support was significantly associated with PSD and PSA, and its effect on PSD exceeded that of physical disability (mRS).

Conclusions:

• Post-stroke depression significantly increases in the long term, whereas emotional incontinence and anger tend to decrease.
• Lack of social support emerges as a more critical factor than physical disability in driving long-term post-stroke depression.