Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-25T04:43:33.856Z Has data issue: false hasContentIssue false
  • English
  • Français

Premorbid personality traits are associated with post-stroke behavioral and psychological symptoms: a three-month follow-up study in Perth, Western Australia

Published online by Cambridge University Press:  09 July 2009

Kathryn R. Greenop ,
Osvaldo P. Almeida ,
Graeme J. Hankey ,
Frank van Bockxmeer  and
Nicola T. Lautenschlager
Kathryn R. Greenop*
Affiliation:
WA Centre for Health and Ageing, University of Western Australia, Perth, Australia
Osvaldo P. Almeida
Affiliation:
WA Centre for Health and Ageing, University of Western Australia, Perth, Australia School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, Australia Department of Psychiatry, Royal Perth Hospital, Perth, Australia
Graeme J. Hankey
Affiliation:
Department of Neurology, Royal Perth Hospital, Perth, Australia
Frank van Bockxmeer
Affiliation:
School of Surgery and Pathology, University of Western Australia, Perth and Cardiovascular Genetics Laboratory, Division of Laboratory Medicine, Royal Perth Hospital, Perth, Australia
Nicola T. Lautenschlager
Affiliation:
WA Centre for Health and Ageing, University of Western Australia, Perth, Australia School of Psychiatry and Clinical Neuroscience, University of Western Australia, Perth, Australia Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Victoria, Australia
*
Correspondence should be addressed to: Dr. Kathryn Greenop, WA Centre for Health and Ageing, M573, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. Phone: +61-8-9224 2392; Fax +61-8-9224 8005. Email: [email protected].
Get access

Abstract

Background: Previous research has found an association between post-stroke depressive symptoms and premorbid personality. This study sought to investigate further the relationship between premorbid personality and a number of common post-stroke behavioral and psychological symptoms in a three-month follow-up study.

Methods: This prospective study was conducted between May 2003 and January 2005 in a Perth metropolitan teaching hospital. The pre-stroke personality of stroke survivors was assessed by interviewing a close family member (informant) within four weeks of the index stroke using the NEO Personality Inventory-Revised. Three months after the stroke, patients were followed up and assessed with the Cambridge Cognitive examination and Hospital Anxiety and Depression Scale, and their informants completed the Neuropsychiatric Inventory-carer distress version (NPI) and instrumental activities of daily living scale.

Results: Depressive symptoms were the most commonly reported post-stroke symptom (45.1%). Spearman's correlations showed that high neuroticism was positively correlated with NPI total scores (ρ = 0.37, p = 0.007), NPI total distress scores (ρ = 0.47, p = 0.001), and specifically with agitation and irritability NPI composite scores. Agreeableness was inversely correlated with agitation (ρ = −0.40, p = 0.004) and irritability (ρ = −0.37, p = 0.007) composite scores.

Conclusions: Premorbid personality traits of high neuroticism and low agreeableness are associated with the presence of post-stroke agitation, irritability, and carer distress. This knowledge may contribute to the development of strategies designed to identify patients and families who require more intense supervision and support during post-stroke rehabilitation.

Keywords

stroke outcomescaregiver distressagitationirritabilitydepression
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 6 , December 2009 , pp. 1063 - 1071
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aben, I., Denollet, J., Lousberg, R., Verhey, F., Wojciechowski, F. and Honig, A. (2002a). Personality and vulnerability to depression in stroke patients: a one-year prospective follow-up study. Stroke, 33, 2391–2395.CrossRefGoogle Scholar
Aben, I., Verhey, F., Lousberg, R., Lodder, J. and Honig, A. (2002b). Validity of the Beck Depression Inventory, Hospital Anxiety and Depression Scale, SCL-90, and Hamilton Depression Rating Scale as screening instruments for depression in stroke patients. Psychosomatics, 43, 386–393.CrossRefGoogle ScholarPubMed
Angelelli, P. et al. (2004). Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study. Acta Psychiatrica Scandinavica, 110, 53–63.Google Scholar
Archer, N. et al. (2007). Premorbid personality and behavioral and psychological symptoms in probable Alzheimer disease. American Journal of Geriatric Psychiatry, 15, 202–213.CrossRefGoogle ScholarPubMed
Bozikas, V. P. et al. (2005). Pathological correlates of poststroke depression in elderly patients. American Journal of Geriatric Psychiatry, 13, 166–169.CrossRefGoogle ScholarPubMed
Bryer, J. B., Starkstein, S. E., Votypka, V., Parikh, R. M., Price, T. R. and Robinson, R. G. (1992). Reduction of CSF monamine metabolites in post-stroke depression: a preliminary report. Journal of Neuropsychiatry and Clinical Neurosciences, 4, 440–442.Google Scholar
Carson, A. J. et al. (2000). Depression after stroke and lesion location: a systematic review. Lancet, 356, 122–126.CrossRefGoogle ScholarPubMed
Costa, P. T. Jr., and McCrae, R. R. (1992). Revised NEO Personality Inventory (NEO-PI-R) and NEO Five Factor Inventory (NEO-FFI) Professional Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Duke University Center for the Study of Aging and Human Development (1978). Multidimensional Functional Assessment Questionnaire. Durham, NC: Duke University.Google Scholar
Franzen-Dahlin, A., Billing, E., Nasman, P., Martensson, B., Wredling, R. and Murray, V. (2006). Post-stroke depression: effect on the life situation of the significant other. Scandinavian Journal of Caring Sciences, 20, 412–416.Google Scholar
Herrmann, C. (1997). International experiences with the Hospital Anxiety and Depression Scale: a review of validation data and clinical results. Journal of Psychosomatic Research, 42, 17–41.CrossRefGoogle Scholar
Hixson, J. E. and Vernier, D. T. (1990). Restriction isotyping of human apolipoprotein E by gene amplification and cleavage with HhaI. Journal of Lipid Research, 31, 545–548.CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. (1998). Assessing the impact of neuropsychiatric symptoms of Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210–215.CrossRefGoogle ScholarPubMed
Kim, J. S., Choi, S., Kwon, S. U. and Seo, Y. S. (2002). Inability to control anger or aggression after stroke. Neurology, 58, 1106–1108.Google Scholar
Morris, P. L. P. and Robinson, R. G. (1995). Personality neuroticism and depression after stroke. International Journal of Psychiatry in Medicine, 25, 93–102.CrossRefGoogle ScholarPubMed
Morrison, V., Pollard, B., Johnston, M. and MacWalter, R. (2005). Anxiety and depression 3 years following stroke: demographic, clinical and psychological predictors. Journal of Psychosomatic Research, 59, 209–213.CrossRefGoogle ScholarPubMed
Nys, G. M. S., van Zandvoort, M. J. E., Van Der Worp, H. B., de Haan, E. H. F., de Kort, P. L. M. and Kappelle, L. J. (2005). Early depressive symptoms after stroke: neuropsychological correlates and lesion characteristics. Journal of the Neurological Sciences, 228, 27–33.Google Scholar
Rasquin, S., Lodder, J. and Verhey, F. (2005). The association between psychiatric and cognitive symptoms after stroke: a prospective study. Cerebrovascular Diseases, 19, 309–316.Google Scholar
Robinson, R. G., Bolduc, P. L. and Price, T. R. (1987). Two-year longitudinal study of poststroke mood disorders: diagnosis and outcome at one and two years. Stroke, 18, 837–843.Google Scholar
Roth, M. et al. (1986). CAMDEX: a standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698–709.CrossRefGoogle Scholar
Ruiz, J. M., Matthews, K. A., Scheier, M. F. and Schulz, R. (2006). Does who you marry matter for your health? Influence of patients’ and spouses’ personality on their partners’ psychological well-being following coronary artery bypass surgery. Journal of Personality and Social Psychology, 91, 255–267.CrossRefGoogle ScholarPubMed
Scarmeas, N. et al. (2002). Association between the APOE genotype and psychopathologic symptoms in Alzheimer's disease. Neurology, 58, 1182–1188.CrossRefGoogle ScholarPubMed
Storer, D. L. and Byrne, G. J. A. (2006). Pre-morbid personality and depression following stroke. International Psychogeriatrics, 18, 457–469.CrossRefGoogle Scholar
Strauss, M. E., Lee, M. M. and DiFilippo, J. M. (1997). Premorbid personality and behavioral symptoms in Alzheimer disease: some cautions. Archives of Neurology, 54, 257–259.Google Scholar
Warlow, C. et al. . (eds.) (2008). Stroke: Practical Management, 3rd edn. Oxford: Blackwell Publishing.CrossRefGoogle Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed