Abstract
Background: High rates of psychological distress are reported in functional conditions and vascular stroke but there is limited understanding of how patients with functional neurological symptoms in stroke settings respond to symptoms.
Aims: This study compared patients with functional stroke symptoms to those with vascular stroke and chronic fatigue syndrome (CFS).
Methods: A prospective cohort of fifty-six patients with functional stroke symptoms were age-sex matched to patients with vascular stroke and CFS. Analysis of variance compared groups on cognitive and behavioural responses to symptoms, psychological distress and functioning. Sensitivity analyses controlled for known confounders. The proportions of clinical anxiety and depression were compared between groups.
Results: The functional stroke symptom group had a higher proportion of clinical anxiety cases compared to the CFS group, and a higher proportion of clinical depression cases compared to the vascular stroke group. Patients with functional stroke symptoms reported the highest rate of ‘damage beliefs’ and ‘all-or-nothing’ behaviours and greater symptom focussing and resting behaviour than patients with vascular stroke.
Limitations: Larger cohorts and a longitudinal design would strengthen study findings.
Conclusion: Compared to patients with vascular stroke or CFS, patients with functional stroke symptoms show a somewhat distinct profile of illness-related beliefs, behaviours, and cognitions, as well as higher rates of clinical anxiety . Understanding such group differences provides some insights into aetiology and cognitive-behavioural responses. Appropriate support and referrals should be available to patients with functional stroke symptoms to address distress and reduce likelihood of severe impairment.
Aims: This study compared patients with functional stroke symptoms to those with vascular stroke and chronic fatigue syndrome (CFS).
Methods: A prospective cohort of fifty-six patients with functional stroke symptoms were age-sex matched to patients with vascular stroke and CFS. Analysis of variance compared groups on cognitive and behavioural responses to symptoms, psychological distress and functioning. Sensitivity analyses controlled for known confounders. The proportions of clinical anxiety and depression were compared between groups.
Results: The functional stroke symptom group had a higher proportion of clinical anxiety cases compared to the CFS group, and a higher proportion of clinical depression cases compared to the vascular stroke group. Patients with functional stroke symptoms reported the highest rate of ‘damage beliefs’ and ‘all-or-nothing’ behaviours and greater symptom focussing and resting behaviour than patients with vascular stroke.
Limitations: Larger cohorts and a longitudinal design would strengthen study findings.
Conclusion: Compared to patients with vascular stroke or CFS, patients with functional stroke symptoms show a somewhat distinct profile of illness-related beliefs, behaviours, and cognitions, as well as higher rates of clinical anxiety . Understanding such group differences provides some insights into aetiology and cognitive-behavioural responses. Appropriate support and referrals should be available to patients with functional stroke symptoms to address distress and reduce likelihood of severe impairment.
| Original language | English |
|---|---|
| Journal | European Journal of Health Psychology |
| Publication status | Accepted/In press - 28 Jun 2021 |
Keywords
- unctional neurological conditions
- Stroke
- Case-control
- cognition
- Psychology
