Emotional behavior in acute stroke: the Lausanne emotion in stroke study.
OBJECTIVE
To study emotional behaviors in an acute stroke population.


BACKGROUND
Alterations in emotional behavior after stroke have been recently recognized, but little attention has been paid to these changes in the very acute phase of stroke.


METHODS
Adult patients presenting with acute stroke were prospectively recruited and studied. We validated the Emotional Behavior Index (EBI), a 38-item scale designed to evaluate behavioral aspects of sadness, aggressiveness, disinhibition, adaptation, passivity, indifference, and denial. Clinical, historical, and imaging (computed tomography/magnetic resonance imaging) data were obtained on each subject through our Stroke Registry. Statistical analysis was performed with both univariate and multivariate tests.


RESULTS
Of the 254 patients, 40% showed sadness, 49% passivity, 17% aggressiveness, 53% indifference, 76% disinhibition, 18% lack of adaptation, and 44% denial reactions. Several significant correlations were identified. Sadness was correlated with a personal history of alcohol abuse (r = P < 0.037), female gender (r = P < 0.028), and hemorrhagic nature of the stroke (r = P < 0.063). Aggressiveness was correlated with a personal history of depression (r = P < 0.046) and hemorrhage (r = P < 0.06). Denial was correlated with male gender (r = P < 0.035) and hemorrhagic lesions (r = P < 0.05). Emotional behavior did not correlate with either neurologic impairment or lesion localization, but there was an association between hemorrhage and aggressive behavior (P < 0.001), lack of adaptation (r = P < 0.015), indifference (r = P < 0.018), and denial (r = P < 0.045).


CONCLUSIONS
Systematic observations of acute emotional behaviors after stroke suggest that emotional alterations are independent of mood and physical status and should be considered as a separate consequence of stroke.
Aybek
Selma
S
Department of Neurology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
Carota
Antonio
A
Ghika-Schmid
Florence
F
Berney
Alexandre
A
Melle
Guy Van
GV
Guex
Patrice
P
Bogousslavsky
Julien
J
D000208:Acute Disease; D000342:Affective Symptoms / Q000209:etiology*; D000368:Aged; D000374:Aggression; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000150:complications* / Q000523:psychology*