Catastrophic reaction after cerebrovascular lesions: frequency, correlates, and validation of a scale.
The frequency and correlates of the catastrophic reaction (CR) were examined in 52 consecutive patients with an acute stroke lesion. A new scale proved reliable for measuring the severity of CR. The CR was significantly associated with depression, a personal and family history of psychiatric disorder, and subcortical lesions, which were mostly located in the basal ganglia. Patients with and without a CR, when matched for the presence and type of depression, differed only in that CR patients had significantly more anterior lesions and a significantly higher frequency of subcortical damage. Results demonstrate that the CR is significantly associated with poststroke depression and may be a specific manifestation of certain types of poststroke depression.
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.
S E
SE
Starkstein
J P
JP
Fedoroff
T R
TR
Price
R
R
Leiguarda
R G
RG
Robinson
D000328:Adult; D000342:Affective Symptoms / Q000209:etiology*; D000368:Aged; D000704:Analysis of Variance; D002561:Cerebrovascular Disorders / Q000523:psychology*; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed