Correlations between Neurologic and Psychiatric Symptoms in Acute Stroke Patients

Kang, Hee Ju; Bae, Kyung Yeol; Kim, Sung Wan; Kim, Jae Min; Shin, Il Seon; Park, Man Seok; Cho, Ki Hyun; Yoon, Jin Sang

Abstract

OBJECTIVES
This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke.
METHODS
For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment).
RESULTS
At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items.
CONCLUSIONS
More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.