Poststroke agitation and aggression and social quality of life: a case control study.
Aggression and agitation are common after a stroke. The association between agitation/aggression following stroke and Health-Related Quality of Life (HRQoL) in stroke survivors is unknown. This study aimed to examine the association between agitation/aggression and HRQoL in Chinese stroke survivors.



Three hundred and twenty-four stroke patients entered this cross-sectional study. Agitation/aggression was assessed using the Chinese version of Neuropsychiatric Inventory (CNPI). HRQoL was measured with the Stroke Specific Quality of Life (SSQoL).



Three months after the index stroke, agitation/aggression was found in 60 (18.5%) patients. In the agitation/aggression group, 44 patients (73.3%) showed passive agitation/aggression, whereas 16 (26.7%) displayed passive and active agitation/aggression. No patients showed only active agitation/aggression. Patients with agitation/aggression were more likely to have history of diabetes and greater severity of depression, as well as lower SSQoL total score and Personality Changes and Social Role scores. Controlling for diabetes and depression severity did not alter the above results. The Energy and Thinking scores of the SSQoL were significantly lower in the passive/active agitation/aggression group relative to the passive agitation/aggression group (adjusted for CNPI aggression/agitation score).



In this study sample, agitation/aggression was preponderantly of the passive type and was associated with poorer HRQoL independently from depression or medical conditions. Patients with both passive and active agitation/aggression had lower Quality of Life (QoL) than patients with only passive agitation/aggression. The causality of the association between low QoL and agitation/aggression needs to be explored in future studies.
a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China.
Chieh Grace
CG
Lau
a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China.
Wai Kwong
WK
Tang
a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China.
Xiang Xin
XX
Liu
a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China.
Hua Jun
HJ
Liang
a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong SAR , China.
Yan
Y
Liang
b Department of Medicine and Therapeutics , Chinese University of Hong Kong , Hong Kong SAR , China.
Adrian
A
Wong
b Department of Medicine and Therapeutics , Chinese University of Hong Kong , Hong Kong SAR , China.
Vincent
V
Mok
c School of Psychiatry & Clinical Neurosciences , University of Western Australia , Perth , Australia.|d Department of Psychiatry , University of Notre Dame Australia/Marian Centre , Perth , Australia.
Gabor S
GS
Ungvari
b Department of Medicine and Therapeutics , Chinese University of Hong Kong , Hong Kong SAR , China.
Ka Sing
KS
Wong
e Department of Neurology , Asan Medical Center, University of Ulsan , Seoul , Korea.
Jong S
JS
Kim
f Una Mano per la Vita - Association of Families and their Doctors , Catania , Italy.|g Facultad de Psicología , Universidad Diego Portales , Santiago , Chile.
Sergio
S
Paradiso
D000368:Aged; D000374:Aggression / Q000502:physiology*; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000209:etiology*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D057566:Self Report; D012919:Social Behavior; D020521:Stroke / Q000150:complications* / Q000523:psychology*
Active; Aggression; Agitation; Health-related quality of life; Passive; Stroke