Emotional and behavioral problems in adolescents following childhood arterial ischemic stroke

Although the psychological impact of stroke on children and adults is well known, there is still limited knowledge about its impact on adolescents. This retrospective study examined the prevalence of emotional and behavioral problems in 33 adolescents following childhood arterial ischemic stroke (AIS; age at stroke: M = 10.4 years, SD = 4.13, range = 1-15; time since stroke: M = 3.9 years, SD = 3.2, range = 0.27-12) administering the CBCL questionnaire to adolescents and their parents. Results indicate elevated psychological problems reported by both adolescents and their parents, with clinical or subclinical scores in Total problems observed in 33% of cases compared to the expected 9.8%. These difficulties include both emotional (49% observed) and behavioral (30% observed) issues and reduced Total competences. In addition, a discrepancy emerged between what parents and adolescents reported, with parents reporting lower internalizing problems than their children. Clinical impairment in the Total Competences subscale was significantly associated with anterior circulation lesions and poor functional outcomes measured by PSOM. In addition, externalizing problems were related to anterior circulation lesions. No other significant associations were observed. Results suggest that routinely including psychological assessment in the clinical follow-up of these patients, considering both the parents and the adolescent's perspective, is necessary to promptly identify individuals who may need psychological support.