Mood and coping skills important after stroke

NEW YORK (Reuters Health) - Symptoms of depression or anxiety are a strong sign that quality of life will be poor for people who've suffered a type of stroke called a subarachnoid hemorrhage, investigators in the Netherlands report.

In a separate report, the researchers also describe the long-term negative impact of stroke on spouses; however, adopting an active coping style may ease the difficulties.

The findings appear in the American Heart Association's journal Stroke.

"The major point is to look beyond physical symptoms and look at psychological symptoms and personality characteristics to evaluate quality of life," Dr. J. M. Anne Visser-Meily, lead author of both studies, said in an AHA statement. These recommendations also apply to patients' spouses "as part of a family-centered approach," she and her associates note.

Visser-Meily, at University Medical Center, Utrecht, and her colleagues examined the effects of psychological symptoms and personality characteristics on quality of life related to health among 141 independently living stroke patients up to four years after they suffered a subarachnoid hemorrhage.

A standard questionnaire showed that while scores in physical areas were relatively high, scores were lower in emotional and social aspects of life.

Mood, fatigue, and cognitive problems were strongly related to all aspects of quality of life, according to the article. Personality characteristics of neuroticism and passive coping style were also tied to worse quality of life.

These personality characteristics may help identify patients who would benefit from targeted therapies in order to improve their long-term quality of life, the team suggests.

In the second study, Visser-Meily and colleagues studied changes in psychosocial functioning in 211 caregivers after their spouses went through stroke rehabilitation.

Although caregiving burdens decreased over time, harmony in couples' relationships deteriorated, as did social relations and depression in caregivers. A passive coping strategy was associated with worse problems.

The investigators advise, "Psychosocial interventions should, if applicable, teach spouses how to cope actively with the consequences of the stroke, how to decrease the negative consequences for family functioning and harmony in the relationship, and how to ask for support."

SOURCE: Stroke, May 2009, online December 19, 2008.