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Mario F Dulay, Caitlin B Dulay, Kieran D Paddock, and Riya Sreenivasan
Houston Methodist Neurological Institute, USA Texas A&M University, USA
ScientificTracks Abstracts: Psychiatry Ment. Health Res
Statement of the problem: Neuro psychiatric disorders after stroke (NDS) are prevalent ranging anywhere from 5-84% for depression and up to near 30% for anxiety. Up to 20% of patients may experience pseudobulbar affect and up to 33% experience poststroke apathy. NDS may occur due to environmental factors or biological factors. In this study, we used DSM criteria to quantify the prevalence of specific NDS and studied associations among NDS and demographic, disease-characteristic, and psychosocial factors. Methodology & Theoretical Orientation: Two-hundred and two stroke survivors (46% men, average age of 59.2 years) were evaluated approximately 13 months after unilateral focal CVA. Poststroke depression (PSD) and poststroke anxiety were diagnosed using DSM-5 criteria with the Mini International Neuropsychiatric Inventory. Apathy was operationalized as diminished goal-directed behavior and reduced initiation that impacted daily life. PBA was defined by the CNS-LS. Findings: PSD was diagnosed in 29.8% of patients, anxiety in 18.6%, apathy in 27.3%, and PBA in 28.2% of patients. Specific anxiety disorders included panic attacks (8% of sample), generalized anxiety disorder (GAD, 7.6% of sample), PTSD (0.9% of sample), social anxiety (2.4% of sample). Logistic regression indicated that poststroke depression, sleep difficulties, and female gender were associated with poststroke anxiety. Patients who experienced post-stroke apathy were 7.1 times more likely to not return-to-work after stroke, those who suffered from PBA were 4.8 times more likely to not return, and those with memory loss were 6.6 times more likely to not return. Conclusion & Significance: Results highlight the importance of neuropsychiatric disorders after stroke. Identifying specific NDS would help to facilitate efforts for pharmacologic and behavioral interventions to improve quality of life and psychosocial outcomes such as return-to- work. Recent publications 1. Dulay, M. F., Criswell, A., & Hodics, T. M. (2023). Biological, Psychiatric, Psychosocial, and Cognitive Factors of Poststroke Depression. International journal of environmental research and public health, 20(7), [5328]. 2. Agbayani, K. A., Dulay, M. F., Romero, R. A. A., & Ordoñez, C. (2022). Cultural Sensitivity in Neuropsychological Assessment of Filipinos and Filipino Americans. In Cultural Diversity in Neuropsychological Assessment: Developing Understanding through Global Case Studies (pp. 215-227). Taylor and Francis. 3. Russell, J. A., & Dulay, M. F. (2016). Hastened death in ALS. Neurology, 87(13), 1312-1313.
Mario F Dulay is a neuropsychologist at Houston Methodist Neurological Institute and Director of The Houston Institute for Neuropsychological Knowledge (THINK) laboratory that studies the neurobiological basis of human behavior using neuropsychological, neuroimaging, neurophysiological, and sensory psychophysical methods to better understand the impact of disease on the brain. Collaborating with physicians within the Houston Methodist Neurological Institute, the lab studies various patient populations to understand the interrelationships among neurocognition, emotion, and biology as a function of disease progression or recovery from neurotrauma.
