Dados do Trabalho

Título

Neuropsychiatric Disorders In Post-Stroke Patients

Resumo

Introduction: Stroke patients have a high prevalence of neuropsychiatric disorders. Post-stroke depression, for instance, can affect around a third of these patients, in addition to the occurrence of anxiety disorders, post-traumatic stress disorder, bipolar disorder and others. However, psychiatric diagnosis and treatment is still limited. Objectives: We aimed to identify the prevalence of neuropsychiatric disorders in patients previously diagnosed with stroke and compare commonly used depression and anxiety assessment scales to a structured interview, in order to assess their reliability in this population. Methods: We evaluated ischemic stroke patients. Sociodemographic, health data and information on brain lesion location were collected and the Mini-International Neuropsychiatric Interview (M.I.N.I) was applied for diagnosis of neuropsychiatric disorders. The Beck (BDI-II and BAI) and Hamilton (HAM-D, HAM-A) depression and anxiety scales were then applied, at same day, for comparison and analysis. Results: Of 81 included participants, 45.7% were diagnosed with at least one neuropsychiatric disorder. Post-stroke depression had the highest prevalence (35.8%), followed by anxiety disorders (34.6%), post-traumatic stress disorder (7.4%), obsessive-compulsive disorder (6.2%), and other (4.93%). Only 14.8% of participants had a psychiatric diagnosis at the moment of the interview. Brain lesion location was not statistically relevant. The depression rating scales BDI-II and HAM-D had an accuracy of 97% and 96%, respectively, when compared to M.I.N.I as the gold standard. The anxiety rating scales, BAI and HAM-A, accuracy of 91% and 92%, respectively. Conclusions: The prevalence of neuropsychiatric disorders in post stroke patients is high, being underdiagnosed and undertreated. The Beck and Hamilton depression and anxiety scales can be used in this population with good accuracy and reliability, improving screening, diagnosis and follow-up of these patients.