title: Emotional behavior in acute stroke: the Lausanne emotion in stroke study.
abstract: 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.
authors.affiliation: Department of Neurology, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland.
authors.forename: Selma
authors.initials: S
authors.lastname: Aybek
authors.forename: Antonio
authors.initials: A
authors.lastname: Carota
authors.forename: Florence
authors.initials: F
authors.lastname: Ghika-Schmid
authors.forename: Alexandre
authors.initials: A
authors.lastname: Berney
authors.forename: Guy Van
authors.initials: GV
authors.lastname: Melle
authors.forename: Patrice
authors.initials: P
authors.lastname: Guex
authors.forename: Julien
authors.initials: J
authors.lastname: Bogousslavsky
mesh_terms: 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*