Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke

Carolin Hoyer,1 Hanna Luise Schmidt,1 Laura Kranaster,2 Angelika Alonso11Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; 2Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg...

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Autores principales:	Hoyer C, Schmidt HL, Kranaster L, Alonso A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	stroke psychiatric disorder comorbidity Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/4f78e3103d4d45208ae917529c63b8e8
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spelling	oai:doaj.org-article:4f78e3103d4d45208ae917529c63b8e82021-12-02T03:08:22ZImpact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke1178-2021https://doaj.org/article/4f78e3103d4d45208ae917529c63b8e82019-07-01T00:00:00Zhttps://www.dovepress.com/impact-of-psychiatric-comorbidity-on-the-severity-short-term-functiona-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Carolin Hoyer,1 Hanna Luise Schmidt,1 Laura Kranaster,2 Angelika Alonso11Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; 2Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyBackground and purpose: The comorbidity of psychiatric disorders and cerebrovascular disease appears to be complex with underlying bidirectional influences. Hitherto, research has focused mainly on the evaluation of stroke risk in particular psychiatric disorders; only a few studies have assessed their role in the acute natural history of stroke. The aim of this study was to provide a perspective on psychiatric premorbidity and its impact on stroke severity, psychiatric complications during the initial treatment phase, and the short-term functional outcome of stroke.Patients and methods: We retrospectively studied the impact of a predocumented psychiatric diagnosis (PDPD) on stroke severity, short-term functional outcome, and psychiatric complications in a sample of 798 patients consecutively admitted for acute ischemic or hemorrhagic stroke by performing a chart review. Group comparisons (PDPD vs non-PDPD) with adjustment for covariates were carried out either using multivariate analysis of variance or logistic regression analysis.Results: More severe strokes (ie, mean National Institute of Health Stroke Scale score on admission 10.1±7.9 vs 7.5±7.4; F(10,796)=18.5, p<0.0001) and higher prevalence of poor outcome (73.7 vs 54.9%; OR: 2.6, standard error: 0.5, z=4.82, p<0.0001) was found in patients with a documented psychiatric diagnosis at the time of stroke, as well as a higher rate of psychiatric complications during the initial treatment phase (46.7 vs 28.9%; OR: −0.78, z=4.59, p<0.0001).Conclusion: Our data have clinical implications in that they call for identification of psychiatric premorbidity or comorbidity through careful history-taking and particularly close monitoring for psychiatric complications with respect to their potentially negative impact on outcome after stroke.Keywords: stroke, psychiatric disorder, comorbidityHoyer CSchmidt HLKranaster LAlonso ADove Medical Pressarticlestrokepsychiatric disordercomorbidityNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1823-1831 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	stroke psychiatric disorder comorbidity Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	stroke psychiatric disorder comorbidity Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Hoyer C Schmidt HL Kranaster L Alonso A Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
description	Carolin Hoyer,1 Hanna Luise Schmidt,1 Laura Kranaster,2 Angelika Alonso11Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; 2Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyBackground and purpose: The comorbidity of psychiatric disorders and cerebrovascular disease appears to be complex with underlying bidirectional influences. Hitherto, research has focused mainly on the evaluation of stroke risk in particular psychiatric disorders; only a few studies have assessed their role in the acute natural history of stroke. The aim of this study was to provide a perspective on psychiatric premorbidity and its impact on stroke severity, psychiatric complications during the initial treatment phase, and the short-term functional outcome of stroke.Patients and methods: We retrospectively studied the impact of a predocumented psychiatric diagnosis (PDPD) on stroke severity, short-term functional outcome, and psychiatric complications in a sample of 798 patients consecutively admitted for acute ischemic or hemorrhagic stroke by performing a chart review. Group comparisons (PDPD vs non-PDPD) with adjustment for covariates were carried out either using multivariate analysis of variance or logistic regression analysis.Results: More severe strokes (ie, mean National Institute of Health Stroke Scale score on admission 10.1±7.9 vs 7.5±7.4; F(10,796)=18.5, p<0.0001) and higher prevalence of poor outcome (73.7 vs 54.9%; OR: 2.6, standard error: 0.5, z=4.82, p<0.0001) was found in patients with a documented psychiatric diagnosis at the time of stroke, as well as a higher rate of psychiatric complications during the initial treatment phase (46.7 vs 28.9%; OR: −0.78, z=4.59, p<0.0001).Conclusion: Our data have clinical implications in that they call for identification of psychiatric premorbidity or comorbidity through careful history-taking and particularly close monitoring for psychiatric complications with respect to their potentially negative impact on outcome after stroke.Keywords: stroke, psychiatric disorder, comorbidity
format	article
author	Hoyer C Schmidt HL Kranaster L Alonso A
author_facet	Hoyer C Schmidt HL Kranaster L Alonso A
author_sort	Hoyer C
title	Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
title_short	Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
title_full	Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
title_fullStr	Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
title_full_unstemmed	Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
title_sort	impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/4f78e3103d4d45208ae917529c63b8e8
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Impact of psychiatric comorbidity on the severity, short-term functional outcome, and psychiatric complications after acute stroke

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