Functional stroke symptoms: A prospective observational case series
| Autor: | Nicola O'Connell, Trudie Chalder, Anthony S. David, Abigail Smakowski, Abbeygail Jones |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Weakness medicine.medical_specialty Hospital Anxiety and Depression Scale 03 medical and health sciences 0302 clinical medicine Medicine Humans 030212 general & internal medicine Longitudinal Studies Prospective Studies Stroke Depression (differential diagnoses) business.industry Medical record Middle Aged medicine.disease Psychiatry and Mental health Clinical Psychology Distress Physical therapy Anxiety Observational study Female medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of psychosomatic research. 132 |
| ISSN: | 1879-1360 |
| Popis: | Objective Functional symptoms are a common mimic of stroke in acute stroke settings, but there are no guidelines on how to manage such patients and scant research on their clinical profile. We explore the presentation of patients with functional stroke symptoms at admission and 2-month follow-up. Methods We conducted a prospective observational study across four SE London acute stroke units, with two-month follow-up. Demographic information, clinical data and GP attendances were recorded. Patients completed self-report measures: Cognitive Behavioural Responses Questionnaire short version, Brief Illness Perception Questionnaire, Hospital Anxiety and Depression Scale, Work and Social Adjustment Scale and Short Form Health Survey. Results Fifty-six patients (mean age: 50.9 years) were recruited at baseline; 40 with isolated functional symptoms, the remaining functional symptoms in addition to stroke. Thirty-one completed self-report follow-up measures. Of 56 participants, 63% were female. Patients presented symptoms across modalities, with unilateral and limb weakness the most frequent. There was inconsistent and ambiguous recording of symptoms on medical records. Approximately 40% of patients reported levels of anxiety and depression above the threshold indicating a probable diagnosis. Higher anxiety was associated with greater resting or all-or-nothing behaviours, embarrassment avoidance and symptom focussing on the CBRQ. Only SF-36 physical functioning improved at follow-up. Less than 50% who responded at follow-up were accessing a treatment, though 82% had ongoing symptoms. Conclusion Patients with functional symptoms in stroke settings report substantial distress, associated with cognitive-behavioural responses to symptoms. Follow-up data suggest recovery can be slow, indicating access to supportive interventions should be improved. |
| Databáze: | OpenAIRE |
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