Post-Stroke Anxiety and Depression - Special Academic Support

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Nowadays, the gap in the literature regarding depression diagnosis and treatment in post-stroke patients is gaining more attention. According to Quattropani et al. (2018), although individuals also exhibit stress after a stroke, symptoms of depression have started receiving more scientific attention. Recent research has focused on post-stroke anxiety (PSA), which is linked to a worse rehabilitation (Quattropani et al., 2018). The majority of research has looked into depression and anxiety separately in stroke victims. Furthermore, nothing is known regarding how neuropsychological therapy affects the eradication of mood swings two months following a stroke (Quattropani et al., 2018). Although it lessens over the course of six months following a stroke, long-term mental difficulties are relatively common. Brain damage is particularly prevalent in the acute period after a stroke.

The overall problem is that recurring strokes are a concern for stroke survivors with PSD in the following weeks and months following the initial incident. PSD is an unusually unpleasant emotional reaction brought on by failing, frustration, or tragedy (Sun et al., 2018). Every year, there are more people suffering from strokes (FaridahAini, 2021). The effects of such incidents can cause both short and long-term immobility with other conditions; the adequate medication can be costly and time-consuming. This creates anxiety in post-stroke individuals, which can lower their well-being (FaridahAini, 2021). Several trials have shown cognitive-behavioral therapy to lessen depression, although the benefit has not been seen in patients with ischemic stroke. A treatment using cognitive-behavioral therapy addresses and modifies the destructive thoughts and behavioral patterns that cause emotional and physical issues.

FaridahAini, A. W. (2021). Cognitive behaviour Therapy (Cbt) to Reduce Post Ischemic Stroke Depression. Annals of the Romanian Society for Cell Biology, 25(6), 3318-3323.

The purpose of the given study is to ascertain how cognitive behavior therapy (CBT) affects individuals with post-stroke ischemia in terms of depression reduction. In the study, a sample of forty participants within every group was chosen using a continuous sampling technique from the demographic of post-stroke victims at the Puskesmas Semarang Regency. The study conducted by FaridahAini has a quasi-experimental design. Here, the control group received therapy to determine the interventions impact. However, some of the influencing factors were out of their management. Furthermore, depressive conditions in post-stroke ischemic individuals were examined in relation to cognitive therapy, with the control group and the intervention group being distinguished.

As for the variables in the research on the role of CBT in post-stroke ischemic patients, these include CBT as the independent variable and patients as a dependent variable. The measurement methods of variables included surveys. In the first phase of the research, depression in post-stroke ischemic individuals was measured. The next step was to provide a CBT treatment that consisted of three stages and lasted for three days. Post-stroke ischemic depression was assessed on the following day. Univariate analysis was used for all parameters in the data gathering. As a result, due to tests and pre-tests, the studys methods of data gathering can be perceived as reliable and valid.

The findings indicated that both groups experienced mild to moderate depression prior to receiving the treatment. According to this research, the intervention group had a medium depression incidence of 70%. Then, it was identified that the control group had a milder depression incidence of 68.7% before receiving psychotherapy. As per the evaluation of the study, it can be stated that the importance of it is in the proof that patients who get CBT psychotherapy for post-stroke depression show significant improvement in their depression following ischemic post-stroke.

Quattropani, M. C., Geraci, A., Lenzo, V., Chiaie, R. D., & Filastro, A. (2018). Post-stroke anxiety and depression: relationships to cognitive rehabilitation outcome. Clinical Neuropsychiatry, 15(1).

The purpose of this study includes determining the incidence of PSD and PSA in a sample of stroke-affected individuals, assessing the impact of early neurocognitive recovery on anxiousness, depression, and cognitive problems, and investigating the relationships between cognitive performance, stress, and depression in post-stroke patients. Sixty-one individuals hospitalized in an acute rehabilitation facility made up the sample. A stroke was given as the primary diagnosis for forty of the cases. Subjects were tested both during the subacute stroke and two months after the stroke first occurred. Twenty-one orthopedic individuals (10 men, 11 women) who were committed to the exact center for two months of therapy make up the control group. The design of this study is correlational since the study aims to find a connection between treatment and the mental state of the patients, as well as cognitive performance and stroke.

The research variables include patients with stroke (dependent) and neuropsychological intervention (independent). Measurement methods of variables involve tests that help achieve the maximum reliability and validity of the results. A correlational analysis was done to look at the connections between stress, anxiety, and cognitive performance. In the subacute period (T1) and two months following the stroke (T2), participants conducted the MMSE, the Verbal Memory Span and Visuospatial Memory Span, the RCPM, the GRAD, the CIRS, the HAM-A, and HAM-D tests.

The findings revealed a major disparity in patients with left and right hemisphere lesions for verbal span (t= -2.97; p = 0.004) (after Bonferroni adjustment for 11 groups). Three months following a stroke, HRSA scores drastically fell. Only the MMSE and HAM-A had substantial mean effect sizes (d = -1.083 and d = 0.804, respectively), which supported the findings. As a result, patients cognitive performance and anxiety significantly improved, but their depression did not. As per the evaluation of the study, its importance lies within the advocacy of psychological therapy in combination with neuropsychological intervention. The results imply that to straightforward rehabilitative methods in the various phases of the stroke, it is critical to concentrate on anxiety and sadness in post-stroke individuals. This helps necessitate psychological assistance in post-stroke patients.

Sun, C., Yang, F., Wang, C., Wang, Z., Zhang, Y., Ming, D., & Du, J. (2018). Mutual information-based brain network analysis in post-stroke patients with different levels of depression. Frontiers in Human Neuroscience, 12, 1-10.

The study aimed to investigate the aberrant brain connection of stroke patients with various levels of depression via assessment of the characteristics of an MI-based weighted neural network. Within that study, there were seventy-two people with stroke and thirty-five healthy controls (HC). There was no neurological or mental illness incidence in the healthy control group. These individuals were separated into three categories based on their scores on the Hamilton Depression Rating Scale (HDRS). Individuals who fall into the categories of post-stroke non-depression (PSND), post-stroke moderate depression (PSMD), and post-stroke depression (PSD) have corresponding HDRS scores of 5, 620, and >20. The study design is observational due to the lack of intervention and focuses on the neural networks of stroke patients.

As for the research variables, these include brain network performance, being the dependent variable, and stroke, being an independent variable. Using a NicoletOne digital video electroencephalograph, the EEG was captured at 16 scalp loci in accordance with the global 1020 method. An offline study was used to eliminate data that had abnormalities. To find and eliminate any lingering ocular action, researchers also performed independent component analysis (ICA), thus providing the reliability and validity of findings and measurement methods of variables.

The findings indicated that only 20% of the sharpest connections are retained in the neural circuits, given the average MI vectors of four categories. The majority join at more significant thresholds, and there is no substantial difference between any two categories at any of the other 11 of the 21 points where there is a variation in grouping between HC and PSD. HC clusters more frequently than PSD and suggest that healthy people have more grouping in the EEG signals. According to the evaluation of the study, its meaning is to emphasize stroke patients and discover how their depression displayed various connection characteristics. This could help with the diagnosis of PSD based on these characteristics.

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