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Mood disorders in long-term survivors of stroke: associations with brain lesion location and volume

Published online by Cambridge University Press:  09 July 2009

M. Sharpe ,
K. Hawton ,
A. House ,
A. Molyneux ,
P. Sandercock ,
J. Bamford  and
C. Warlow
M. Sharpe*
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
K. Hawton
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
A. House
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
A. Molyneux
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
P. Sandercock
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
J. Bamford
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
C. Warlow
Affiliation:
University Departments of Psychiatry and Neurology, Oxford
*
1Address for correspondence: Dr M. Sharpe, University Department of Psychiatry, Warneford Hospital, Oxford 0X3 7JX.
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Synopsis

Sixty surviving patients from a community-based stroke register who had CT scan evidence of a single brain lesion and neurological signs appropriate to it were interviewed three to five years following their first-ever stroke. Mood disorder (anxiety and depression), physical disability, and intellectual impairment were assessed using standardized measures. The position and volume of the brain lesion was determined from CT scans performed soon after the stroke. The prevalence of depressive disorder was lower in this sample than that reported in previous studies (DSM-IIIR major depression 8 3 %; all DSM-IIIR depressive disorders 183%). Reports by other workers for an association of depressive disorder either with left-sided brain lesions, or with anteriorly placed lesions in the left cerebral hemisphere, were not supported. Neither was there evidence of a correlation between symptom score and proximity of the lesion to the anterior pole of the left cerebral hemisphere. Psychiatric symptom scores were however greater with larger volume brain lesions. Anxiety disorders, especially agoraphobia, were relatively common (20 % if diagnosed in the presence of depressive disorder), but were not related to lesion location or volume.

Type
Orginal Articles
Information
Psychological Medicine , Volume 20 , Issue 4 , November 1990 , pp. 815 - 828
Copyright
Copyright © Cambridge University Press 1990

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References

REFERENCES

Aho, K., Harmsen, P., Hatano, S., Marquardsen, J., Smirniv, V. & Strasser, T. (1980). Cerebrovascular disease in the community; results of a WHO collaborative study. WHO Bulletin 58, 113–130.Google ScholarPubMed
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders revised 3rd edn. APA: Washington, DC.Google Scholar
Bamford, J. (1986). The classification and natural history of acute cerebrovascular disease. M.D. thesis, Unviersity of Manchester.Google Scholar
Bamford, J. & Warlow, C. (1988). The evolution and testing of the lacunar hypothesis. Stroke 19, 1074–1082.CrossRefGoogle ScholarPubMed
Bamford, J., Sandercock, P., Warlow, C. & Gray, M. (1986). Why are patients with acute stroke admitted to hospital? British Medical Journal 292, 1369–1372.CrossRefGoogle ScholarPubMed
Bamford, J., Sandercock, P., Dennis, M., Warlow, C., Jones, L., McPherson, K., Vessey, M., Fowler, G., Molyneux, A., Hughes, T., Burn, J. & Wade, D. (1988). A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981–86. Journal of Neurology, Neurosurgery, and Psychiatry 51, 1373–1380.CrossRefGoogle Scholar
Dennis, M. S., Bamford, J. M., Molyneux, A. J. & Warlow, C. P. (1987). Rapid resolution of signs of primary intra-cerebral haemorrhage in computerized tomograms of the brain. British Medical Journal 295, 379–381.CrossRefGoogle Scholar
Ebrahim, S., Barer, D. & Nouri, F. (1987). Affective illness after stroke. British Journal of Psychiatry 151, 52–56.CrossRefGoogle ScholarPubMed
Enderby, P. M., Wood, V. A., Wade, D. T. & Langton-Hewer, R. (1987). The Frenchay Aphasia Screening Test: a short, simple test for aphasia appropriate for non-specialists. International Journal of Rehabilitation Medicine 8, 166–170.CrossRefGoogle Scholar
Eastwood, M. R., Rifat, S. L., Nobbs, H. & Juderman, J. (1989). Mood disorder following cerebrovascular accident. British Journal of Psychiatry 154, 195–200.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Mini-Mental State’. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle ScholarPubMed
Folstein, M. F., Maiberger, R. & McHugh, P. R. (1977). Mood disorder as a specific complication of stroke. Journal of Neurology, Neurosurgery and Psychiatry 40, 1018–1020.CrossRefGoogle ScholarPubMed
Gardner, M. J. & Altman, D. G., (1986). Confidence intervals rather than P values: estimation rather than hypothesis testing. British Medical Journal 292, 746–750.CrossRefGoogle Scholar
Holbrook, M. & Skilbeck, C. E. (1983). An activities index for use with stroke patients. Age and Ageing 12, 166–170.CrossRefGoogle ScholarPubMed
House, A. (1987). Mood disorders after stroke: a review of the evidence. International Journal of Geriatric Psychiatry 2, 211–221.CrossRefGoogle Scholar
House, A., Dennis, M., Molyneux, A., Warlow, C. & Hawton, K. (1989). Emotionalism after stroke. British Medical Journal 298, 991–994.CrossRefGoogle ScholarPubMed
House, A., Dennis, M., Warlow, C., Hawton, K. & Molyneux, A. (1990 a). Mood disorders in the first year after stroke: a CT scan study of the importance of lesion location. Brain (in the press).CrossRefGoogle Scholar
House, A., Dennis, M., Mogridge, L., Warlow, C., Hawton, K. & Jones, L. (1990 b). Mood disorders in the first year after stroke. British Journal of Psychiatry (in the press).Google ScholarPubMed
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., Rao, K. & Price, T. R. (1983). Mood changes following bilateral hemisphere brain injury. British Journal of Psychiatry 143, 266–273.CrossRefGoogle ScholarPubMed
Mahoney, F. & Barthel, D. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal 14, 61–65.Google ScholarPubMed
Morris, J. A. & Gardner, M. J. (1988). Calculating confidence intervals for relative risks (odds ratios) and standardised ratios and rates. British Medical Journal 296, 1313–1316.CrossRefGoogle ScholarPubMed
Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C. E., Leaf, P. J., Orvaschel, H., Anthony, J. C., Boyd, J. H., Burke, J. D., Kramer, M. & Stoltzman, R. (1984). Six-month prevalence of psychiatric disorder in three communities. Archives of General Psychiatry 41, 959–967.CrossRefGoogle ScholarPubMed
Parikh, R. M., Lipsey, J. R., Robinson, R. G. & Price, T. R. (1987). A two-year longitudinal study of post-stroke mood disorders: dynamic changes in correlates of depression at one and two years. Stroke 18, 579–584.CrossRefGoogle ScholarPubMed
Pullicino, P., Nelson, R. F., Kendall, B. & Marshall, J. (1980). Small deep infarcts diagnosed on computed tomography. Neurology 30, 1090–1096.CrossRefGoogle ScholarPubMed
Robinson, R. G. & Price, T. R. (1982). Post-stroke depressive disorders: a follow-up study of 103 patients. Stroke 13, 635–641.CrossRefGoogle ScholarPubMed
Robinson, R. G., Shoemaker, W. J., Schlumpf, M., Valk, T. & Bloom, F. E. (1975). Effects of experimental cerebral infarction in rat brain on catecholamines and behaviour. Nature 255, 332–334.CrossRefGoogle ScholarPubMed
Robinson, R. G., Starr, L. B., Kubos, K. L. & Price, T. R. (1983). A two-year longitudinal study of post-stroke mood disorders: findings during the initial evaluation Stroke 14, 736–741.CrossRefGoogle ScholarPubMed
Robinson, R. G., Lipsey, J., Rao, K. & Price, T. (1986). Two year longitudinal study of post-stroke mood disorders: comparison of acute onset with delayed onset depression. American Journal of Psychiatry 143, 1238–1244.Google ScholarPubMed
Robinson, R. G., Starr, L. B. & Price, T. R. (1984 a). A two year longitudinal study of mood disorders following stroke: prevalence and duration at six months follow-up. British Journal of Psychiatry 144, 256–262.CrossRefGoogle ScholarPubMed
Robinson, R. G., Kubos, K. L., Starr, L. B., Rao, K. & Price, T. E. (1984 b). Mood disorders in stroke patients: importance of location of lesion. Brain 107, 81–93.CrossRefGoogle ScholarPubMed
Robinson, R. G., Lipsey, J. R., Bolla-Wilson, K., Bolduc, P. L., Pearlson, G. D., Rao, K. & Price, T. R. (1985). Mood disorders in left-handed stroke patients. American Journal of Psychiatry 142, 1424–1429.Google ScholarPubMed
Robinson, R. G., Bolduc, P. L. & Price, T. R. (1987). Two-year longitudinal study of post stroke mood disorders: diagnosis and outcome at one and two years. Stroke 18, 837–843.CrossRefGoogle Scholar
Sinyor, D., Jacques, P., Kaloupek, D. G., Becker, R., Goldenberg, M. & Coopersmith, H. (1986). Post-stroke depression and lesion location: an attempted replication. Brain 109, 537–546.CrossRefGoogle Scholar
Spitzer, R. L., Williams, J. B. & Gibbon, M. (1986). Instruction Manual for the Structured Clinical Interview for DSM-IIIR. Available from Biometrics Research Department, New York State Psychiatric Institute, New York.Google Scholar
SPSS (1988). Statistical Package for Social Scientists (SPSSX), SPSS Inc: Chicago.Google Scholar
Starkstein, S. E. & Robinson, R. G. (1989). Affective disorders and cerebral vascular disease. British Journal of Psychiatry 154, 170–182.CrossRefGoogle ScholarPubMed
Starkstein, S. E., Robinson, R. G. & Price, T. R. (1987). Comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain 110, 1045–1059.CrossRefGoogle Scholar
Wade, D., Leigh-Smith, J. & Hewer, R. A. (1987). Depressed mood after stroke. A community study of its frequency. British Journal of Psychiatry 151, 200–205.CrossRefGoogle ScholarPubMed
Wells, K., Golding, J. & Burnham, M. (1988). Psychiatric disorder in a sample of the general population with and without chronic medical conditions. American Journal of Psychiatry 145, 976–1022.Google Scholar
Wing, J., Cooper, J. & Sartorious, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, J. K., Mann, S. A., Leff, J. P. & Nikon, J. M. (1978). The concept of a case in psychiatric population surveys. Psychological Medicine 8, 203–217.CrossRefGoogle ScholarPubMed
Zigmond, A. & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed