Psychiatric Disorders as Strokes Sequelae in a Hispanic Population: Retrospective Cohort Study
Objective:
Provide insight into psychiatric disorders as sequelae of strokes in a Hispanic population.
Background:
Strokes produce sequelae depending on type, severity, and location. Psychiatric symptoms can arise in patients who have never had past psychiatric disorders. Physician’s awareness and correct identification of psychiatric sequelae is essential for a well executed patient care.
Design/Methods:
A retrospective study was elaborated by collecting clinical information from a hospital database. The database included Hispanic patients diagnosed with different strokes within 12 months. Patients with a history of psychiatric illnesses were excluded. The clinical data of each patient was analyzed using different statistical methods.
Results:
100 patients were included, of which 66% were men, with a mean age of 61.37±14.57 years (range: 25-89). 57% corresponded to ischemic events, with 37% in the right hemisphere. The most common locations were subcortical (35%), intraparenchymal (28%), and cortical (24%), highlighting the temporal lobe (20%), frontal (19%) and thalamus (13%). 36% of patients developed neuropsychiatric manifestations, with cognitive impairment in 20%, sleep disorders in 19%, behavioral disorders in 17%, depression in 13%, anxiety in 7%, and psychosis in 4%. The time to onset of symptoms was 255.41±418 days (range: 7-2130 days), with a peak at 120 days. The average score on the NIHSS scale at admission was 9.9 ± 9 points, indicating moderate severity. Specifically, depression was significantly related to a NIHSS level score (0-7) (p=0.003). Psychotic disorders were correlated with cortical lesions (p <0.001), and cognitive impairment with subcortical lesions (p=0.043). Sleep disturbances were associated with ischemic lesions (p=0,032; OR=3,482; IC=1,064–11,40) and a bilateral predominance of the event (p=0.029).
Conclusions:
Cognitive impairment was the most prevalent sequelae among psychiatric disorders, while psychosis was the least prevalent. The correlations between NIHSS scores and specific disorders highlight the necessity to address the psychiatric aspect to improve patient’s quality of life following a stroke.
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