[Neuropsychiatric disorders and emotional coping strategies in post-stroke patients. A longitudinal study]

Rev Neurol. 2021 Aug 15;73(4):130-134. doi: 10.33588/rn.7304.2020332.
[Article in Spanish]

Abstract

Introduction: Between one third and one half of the population that has suffered a stroke present with a neuropsychiatric disorder (NPD), which often goes underdiagnosed.

Aim: To study the association between the presence of NPDs and coping strategies in stroke patients.

Subjects and methods: Prospective, longitudinal and comparative study in a sample of patients with ischaemic stroke with and without the presence of NPDs. Both sociodemographic and clinical variables were collected. Neurological impairment (National Institute of Health Stroke Scale) and coping (Brief Coping Orientation to Problems Experienced) were assessed at three and 12 months. The period studied was from 2013 to 2017.

Results: A total of 82 patients were analysed, with a mean age of 67.6 ± 10.4 years, 52.4% of whom were male. Of them, 14 with NPD and 36 without NPD answered the Brief Coping Orientation to Problems Experienced coping scale, and the remaining 32 were excluded because of aphasia/dysphasia. At three months, dimensions of active coping, social support, denial and behavioural disengagement were observed in the NPD group, and at 12 months, denial and behavioural disengagement persisted, and planning, self-distraction and self-incrimination dimensions appeared.

Conclusions: Results show the need to motivate patients to seek more effective strategies, to identify problems when they arise, to consider them as surmountable and to inhibit impulsive or inappropriate responses, replacing them with emotional responses and appropriate behaviours.

Title: Trastornos neuropsiquiátricos y estrategias de afrontamiento emocionales en pacientes postictus. Estudio longitudinal.

Introducción. Entre un tercio y la mitad de la población que ha padecido un ictus presenta un trastorno neuropsiquiátrico (TNp), el cual suele estar infradiagnosticado. Objetivo. Estudiar la asociación entre la presencia de TNp y las estrategias de afrontamiento en pacientes con ictus. Sujetos y métodos. Estudio prospectivo, longitudinal y comparativo en una muestra de pacientes con ictus isquémico con y sin presencia de TNp. Se recogieron variables sociodemográficas y clínicas. Se evaluó la afectación neurológica (National Institute of Health Stroke Scale) y el afrontamiento (Brief Coping Orientation to Problems Experienced) a los tres y a los 12 meses. El período de estudio fue de 2013 a 2017. Resultados. Se analizó a 82 pacientes, con una edad media de 67,6 ± 10,4 años, y eran hombres el 52,4%. De ellos, 14 con TNp y 36 sin TNp respondieron a la escala de afrontamiento Brief Coping Orientation to Problems Experienced, y los 32 restantes fueron excluidos por afasia/disfasia. A los tres meses se observaron dimensiones de afrontamiento activo, apoyo social, negación y desconexión conductual en el grupo TNp, y a los 12 meses persistió la negación y la desconexión conductual, y aparecieron dimensiones de planificación, autodistracción y autoinculpación. Conclusiones. Los resultados muestran la necesidad de motivar a los pacientes a buscar estrategias más eficaces, identificando los problemas cuando aparecen, de considerarlos superables y de inhibir respuestas impulsivas o inadecuadas, sustituyéndolas por respuestas emocionales y conductas adecuadas.

Publication types

  • Multicenter Study

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / drug therapy
  • Anxiety Disorders / etiology*
  • Anxiety Disorders / psychology
  • Apathy
  • Depressive Disorder / drug therapy
  • Depressive Disorder / etiology*
  • Depressive Disorder / psychology
  • Emotions*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Psychological Tests
  • Psychotropic Drugs / therapeutic use
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Socioeconomic Factors
  • Stroke / psychology*

Substances

  • Psychotropic Drugs
  • Serotonin Uptake Inhibitors