Predictors of emotional distress after stroke

Background and Purpose - The aim of this prospective longitudinal study was to identify factors relating to emotional distress in the first 6 months after stroke in a sample including patients with aphasia. Methods - One hundred patients who were in hospital at 1 month after stroke were recruited and assessed on measures of communication impairment ( Sheffield Screening Test), personal activities of daily living ( Barthel Index), and emotional distress ( Visual Analogue Self- Esteem Scale). Demographic and stroke characteristics were recorded. Patients ( n = 92) were reassessed on the same measures 6 months after stroke, in addition to assessing extended activities of daily living ( Nottingham Extended Activities of Daily Living Scale). Results - Patients were aged 44 to 86 years ( 51 men), and 21 were classified as having aphasia. Multiple linear regression showed that expressive communication impairment and dependence in personal activities of daily living were significant predictors of emotional distress at 1 month after stroke ( R-2 = 24%). Expressive communication impairment, emotional distress at 1 month after stroke, and having a more severe stroke were significant predictors of emotional distress at 6 months after stroke ( R-2 = 55%). Distress levels were similar at 1 month and 6 months after stroke. Demographic characteristics and side of lesion were unrelated to distress. Conclusions - Expressive communication impairment and level of disability in personal activities of daily living were related to distress. Distress was persistent in the first 6 months after stroke. Appropriate treatment strategies need to be developed and evaluated for patients who have communication impairments.