Effect on post-stroke anxiety and depression of an early neuropsychological and behavioural treatment

V. Lenzo 1, A. Geraci 2, A. Filastro 3, M.C. Quattropani 4

1 Department of Human, Social and Health Sciences, University of Cassino and South Latium, Italy; 2 Department of Developmental and Social Psychology, University of Padua, Italy; 3 I.P.U.E. Istituto di Psicoterapia Umanistica Esistenziale “Luigi De Marchi”, Rome, Italy; 4 Department of Clinical and Experimental Medicine, University of Messina, Italy

Objectives

Post-stroke depression and anxiety are common psychiatric symptoms that can interfere with the rehabilitation. This study aimed to examine the depression and anxiety levels in the sub-acute phase and at 2 months post-stroke evaluation in a sample of 50 inpatients. This study also evaluated the efficacy of an early neuropsychological and behavioral intervention on anxiety, depression and cognitive functioning. In addition the relationships between anxiety, depression and cognitive functioning were examined. 

Methods

A convenience sample of 50 post-stroke patients was enrolled from an inpatient rehabilitation study. They completed the Mini Mental State Examination (MMSE), the Raven’s Colored Progressive Matrix (RCPM), the Verbal Memory Span and Visuospatial Memory Span, the Hamilton Rating Anxiety Scale (HAM-A), and the Hamilton Rating Scale for Depression (HAM-D) in the subacute phase (T1) and 2 months after stroke (T2). Medical information about the stroke and its characteristics was provided. The neuropsychological part of the treatment was aimed to develop compensating skills, awareness of limits and improvement of cognitive deficits. The behavioral part of the treatment was aimed to teach appropriate behaviors and prepare social reintegration. A control sample of 50 orthopaedic patients well-matched for age, gender, and level of education was enrolled. The two sample were compared for anxiety, depression, and cognitive functioning at T1 and T2. 

Results

Results showed significant differences between patients after stroke and control sample in anxiety and depression. These results persisted at two months after stroke evaluation. Moreover, the neuropsychological and behavioral treatment was efficacy to improve the cognitive functioning and reduce PSD and PSA. 

Conclusions

Findings highlight the importance of anxiety and depression in post-stroke patients in the early phases. Multidisciplinary approach are necessary for a better functional outcome.

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