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Depressive Symptoms and Anger Expression Among Survivors After Stroke

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GeNeDis 2022 (GeNeDis 2022)

Abstract

Introduction: Stroke is a frequent cause of death and one of the most common causes of disability and depression in the countries of the Western world. Depression is associated with limited functionality, reduced self-care, and increased mortality in patients with stroke. Anger often occurs in these patients and may disrupt the course of their recovery. Aim: The investigation of the presence of depressive symptomatology, the expression of anger, and the degree of functioning/independence of patients after stroke. Method: One hundred and ten patients after stroke completed the Center for Epidemiological Studies-Depression (CES-D) scale, the State-Trait Anger Expression Inventory, and the Barthel Index. Results: Patients who lived alone had a higher depressive symptomatology score than patients who did not live alone (p = 0.009). An increase in the total depressive symptomatology score was related to an increase in the anger expression score (p = 0.011), increase in anger-in score (p < 0.001), increase in anger-out score (p < 0.001), and decrease in anger control score (p = 0.001). Females had lower anger-in scores compared to men (p = 0.029). Individuals with a history of previous stroke had higher anger-out scores compared to people without a history of previous stroke (p = 0.025). An increase in the patient’s functional/independence score was associated with an increase in anger control score (p = 0.015). Conclusions: Early detection and management of depression and anger will facilitate patient’s compliance to the rehabilitation program in order to achieve optimal therapeutic results and ensure a better quality of life.

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References

  1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB et al (2012) Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation 125:e2–e220

    PubMed  Google Scholar 

  2. Yang H, Rajah G, Guo A, Wang Y, Wang Q (2018) Pathogenesis of epileptic seizures and epilepsy after stroke. Neurol Res 40:426–432

    Article  PubMed  Google Scholar 

  3. Maaijwee NA, Tendolkar I, Rutten-Jacobs LC, Arntz RM, Schaapsmeerders P, Dorresteijn LD et al (2016) Long-term depressive symptoms and anxiety after transient ischaemic attack or ischaemic stroke in young adults. Eur J Neurol 23:1262–1268

    Article  CAS  PubMed  Google Scholar 

  4. Robinson RG, Jorge RE (2016) Post-stroke depression: a review. Am J Psychiatry 173:221–231

    Article  PubMed  Google Scholar 

  5. Rosa PB, Orquiza B, Rocha FB, Donadel RW, Diniz RP, Beloni TM et al (2016) Anger and stroke: a potential association that deserves serious consideration. Acta Neuropsychiatr 28:346–351

    Article  PubMed  Google Scholar 

  6. Santos AC, Ferro JM (2019) Profile of anger in acute stroke: a multifactorial model of anger determinants. J Neuropsychiatr Clin Neurosci 31:159–164

    Article  Google Scholar 

  7. Spielberger CD (1991) State-trait anger expression inventory-revised research edition: professional manual. Psychological Assessment Resources, Odessa

    Google Scholar 

  8. Raddloff L (1977) The center for epidemiological studies-depression scale: a self-report depression scale for research in the general population. Appl Psychol Meas 3:385–401

    Article  Google Scholar 

  9. Madianos MG, Stefanis CN (1992) Changes in the prevalence of symptoms of depression and depression across Greece. Soc Psychiatry Psychiatr Epidemiol 27:211–219

    Article  CAS  PubMed  Google Scholar 

  10. Spielberger CD, Johnson EH, Russell SF, Crane RJ, Jacobs GA, Worden TJ (1985) The experience and expression of anger: construction and validation of an anger expression scale. In: Chesney MA, Rosenman RH (eds) Anger and hostility in cardiovascular and behavioral disorders. Hemisphere, New York, p 50

    Google Scholar 

  11. Anagnostopoulou T, Kioseoglou G (2012) State–trait anger expression inventory. In: Stalikas A, Triliva S, Roussi P (eds) The psychometric instruments in Greece: a comprehensive collection and presentation of questionnaires, tests, instruments and assessments kits in Greece. Topos, Athens, p 576

    Google Scholar 

  12. Mahoney F, Barthel D (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65

    CAS  PubMed  Google Scholar 

  13. Collin C, Wade D, Davies S et al (1988) The Barthel ADL index: reliability study. Int Disabil Stud 10:61–63

    Article  CAS  PubMed  Google Scholar 

  14. Quin TJ, Langhrome P, Stott DJ (2011) Barthel index for stroke trials: development, properties, and application. Stroke 42:1146–1151

    Article  Google Scholar 

  15. McDowell I, Newell C (1996) Measuring health: a guide to rating scales and questionnaires, 2nd edn. Oxford University Press, New York, pp 63–67

    Google Scholar 

  16. Shah S, Vanclay F, Cooper B (1989) Improving the sensitivity of the Barthel index for stroke rehabilitation. J Clin Epidemiol 42:703–709

    Article  CAS  PubMed  Google Scholar 

  17. Cameron JI, Cheung AM, Streiner DL, Coyte PC, Stewart DE (2011) Stroke survivor depressive symptoms are associated with family caregiver depression during the first 2 years poststroke. Stroke 42:302–306

    Article  PubMed  Google Scholar 

  18. Strober LB, Arnett PA (2009) Assessment of depression in three medically ill, elderly populations: Alzheimer’s disease, Parkinson’s disease and stroke. Clin Neuropsychol 23:205–230

    Article  PubMed  Google Scholar 

  19. Williams LS, Shoma-Ghose S, Swindle RW (2004) Depression and other mental health diagnoses increase mortality risk after ischemic stroke. Am J Psychiatr 161:1090–1095

    Article  PubMed  Google Scholar 

  20. Theeke L, Horstman P, Mallow J, Lucke-Wold N, Culp S, Domico J, Barr T (2014) Quality of life and loneliness in stroke survivors living in Appalachia. J Neurosci Nurs 46:E3–E15

    Article  PubMed  PubMed Central  Google Scholar 

  21. Choi-Kwon S, Han K, Cho KH, Choi S, Suh M, Nah HW, Kim JS (2013) Factors associated with post-stroke anger proneness in ischaemic stroke patients. Eur J Neurol 20:1305–1310

    Article  CAS  PubMed  Google Scholar 

  22. Ramos-Perdigues S, Mane-Santacana A, Pintor-Perez L (2015) Prevalence and associated factors of anger post stroke: a systematic review. Rev Neurol 60(11):481–489

    PubMed  Google Scholar 

  23. Santos AC, Ferro JM (2017) The impact of anger in adherence to treatment and beliefs about disease 1 year after stroke. J Neurol 264:1929–1938

    Article  PubMed  Google Scholar 

  24. Angelopoulou E (2012) Anger management as a means of developing emotional intelligence. Doctoral thesis, Harokopion University, Athens

    Google Scholar 

  25. Galeoto G, Iori F, De Santis R, Santilli V, Mollica R, Marquez MA et al (2019) The outcome measures for loss of functionality in the activities of daily living of adults after stroke: a systematic review. Top Stroke Rehabil 26(3):236–245

    Article  PubMed  Google Scholar 

  26. Guajardo VD, Terroni L, Sobreiro Mde F, Zerbini MI, Tinone G, Scaff M et al (2015) The influence of depressive symptoms on quality of life after stroke: a prospective study. J Stroke Cerebrovasc Dis 24:201–209

    Article  PubMed  Google Scholar 

  27. Aron AW, Staff I, Fortunato G, Mccullough LD (2015) Prestroke living situation and depression contribute to initial stroke severity and stroke recovery. J Stroke Cerebrovasc Dis 24:492–499

    Article  PubMed  Google Scholar 

  28. Wan-Fei K, Hassan STS, Sann LM, Ismail SIF, Raman RA, Ibrahim F (2017) Depression, anxiety and quality of life in stroke survivors and their family caregivers: a pilot study using an actor/partner interdependence model. Electron Physician 9:4924–4933

    Article  PubMed  PubMed Central  Google Scholar 

  29. Huang HC, Chang CH, Hu CJ, Shyu ML, Chen CI, Huang CS et al (2017) Time-varying effects of psychological distress on the functional recovery of stroke patients. Arch Phys Med Rehabil 98:722–729

    Article  PubMed  Google Scholar 

  30. Pascual-Leone A, Gilles P, Singh T, Andreescu CA (2013) Problem anger in psychotherapy: an emotion-focused perspective on hate, rage, and rejecting anger. J Contemp Psychother:1–10. https://doi.org/10.1007/s10879-012-9214-8

  31. Kashihara M, Nakao S, Kawasaki J, Takata S, Nagahiro S, Kaji R et al (2011) Long-term outcome of severe stroke patients: is the ADL status at discharge from a stroke center indicative of the long-term outcome? J Med Investig 58(3, 4):227–234

    Article  Google Scholar 

  32. Kavga A (2016) Health promotion behaviors in family caregivers of stroke patients within the community. PhD thesis, National And Kapodistrian University Of Athens

    Google Scholar 

  33. Phan HT, Blizzard CL, Reeves MJ, Thrift AG, Cadilhac DA, Sturm J et al (2019) Sex differences in long-term quality of life among survivors after stroke in the INSTRUCT. Stroke 50:2299–2306

    Article  PubMed  Google Scholar 

  34. Giralt D, Domingues-Montanari S, Mendioroz M et al (2012) The gender gap in stroke: a meta-analysis. Acta Neurol Scand 125(2):83–90

    Article  CAS  PubMed  Google Scholar 

  35. Hay CC, Graham J, Pappadis MR, Sander AM, Hong I, Reistetter T (2020) The impact of one’s sex and social living situation on rehabilitation outcomes following a stroke. Am J Phys Med Rehabil 99(1):48–54

    Article  PubMed  PubMed Central  Google Scholar 

  36. Roth DL, Haley WE, Clay OJ, Perkins M, Grant JS, Rhodes JD et al (2011) Race and gender differences in 1-year outcomes for community-dwelling stroke survivors with family caregivers. Stroke 42(3):626–631

    Article  PubMed  PubMed Central  Google Scholar 

  37. Trnka R, Stuchlíková I (2011) Anger coping strategies and anger regulation. In: Trnka R (ed) Re-constructing emotional spaces: from experience to regulation. Prague Psychosocial Press, Prague

    Google Scholar 

  38. Bal C, Gül N, Tumurbağa M (2019) Sürekli öfke ve öfke ifade tarzının demografik özelliklerle ilişkisi. Kahramanmaraş Sütçü İmam Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 9(2):63–72

    Google Scholar 

  39. Spielberger CD, Reheiser EC, Sydeman SJ (1995) Measuring the experience, expression, and control of anger. Issues Compr Pediatr Nurs 18(3):207–232

    Article  CAS  PubMed  Google Scholar 

  40. Balhara Υ, Verma R, Sharma S, Mathur S (2012) A study of predictors of anxiety and depression among stroke patient–caregivers. J Midlife Health 3(1):31–35

    PubMed  PubMed Central  Google Scholar 

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Correspondence to Afroditi Zartaloudi .

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Papadopoulou, A. et al. (2023). Depressive Symptoms and Anger Expression Among Survivors After Stroke. In: Vlamos, P. (eds) GeNeDis 2022. GeNeDis 2022. Advances in Experimental Medicine and Biology, vol 1425. Springer, Cham. https://doi.org/10.1007/978-3-031-31986-0_24

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