Psychological distress after stroke and aphasia: the first six months.
OBJECTIVE
We explored the factors that predicted psychological distress in the first six months post stroke in a sample including people with aphasia.


METHODS
Prospective longitudinal observational study.


METHODS
Participants with a first stroke from two acute stroke units were assessed while still in hospital (baseline) and at three and six months post stroke.


METHODS
Distress was assessed with the General Health Questionnaire-12. Other measures included: NIH Stroke Scale, Barthel Index, Frenchay Aphasia Screening Test, Frenchay Activities Index, MOS Social Support Scale and social network indicators. Logistic regression was used to identify predictors of distress at each stage post stroke; and to determine what baseline factors predicted distress at six months.


RESULTS
Eighty-seven participants were able to self-report on measures used, of whom 32 (37%) had aphasia. 71 (82%) were seen at six months, including 11 (16%) with aphasia. Predictors of distress were: stroke severity at baseline; low social support at three months; and loneliness and low satisfaction with social network at six months. The baseline factors that predicted distress at six months were psychological distress, loneliness and low satisfaction with social network (Nagelkerke R(2) = 0.49). Aphasia was not a predictor of distress at any time point. Yet, at three months post stroke 93% of those with aphasia experienced high distress, as opposed to 50% of those without aphasia (chi(2) (1) = 8.61, P<0.01).


CONCLUSIONS
Factors contributing to distress after stroke vary across time. Loneliness and low satisfaction with one's social network are particularly important and contribute to long-term psychological distress.
Hilari
Katerina
K
Department of Language and Communication Science, School of Community and Health Sciences, City University London, London, UK. k.hilari@city.ac.uk
Northcott
Sarah
S
Roy
Penny
P
Marshall
Jane
J
Wiggins
Richard D
RD
Chataway
Jeremy
J
Ames
Diane
D
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008132:Loneliness / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications / Q000523:psychology*; D000071939:Stroke Rehabilitation; D055815:Young Adult