Illness-Related Cognition, Distress and Adjustment in Functional Stroke Symptoms, Vascular Stroke, and Chronic Fatigue Syndrome

TY - JOUR

T1 - Illness-Related Cognition, Distress and Adjustment in Functional Stroke Symptoms, Vascular Stroke, and Chronic Fatigue Syndrome

AU - Jones, Abbeygail

AU - Smakowski, Abigail

AU - Hughes, Alicia

AU - David, Anthony S.

AU - Chalder, Trudie

N1 - Publisher Copyright: © The Author(s), 2022.

PY - 2022/7

Y1 - 2022/7

N2 - 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 56 patients with functional stroke symptoms were age-gender matched to patients with vascular stroke and CFS. Analysis of variance compared groups on cognitive and behavioral 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 than the CFS group, and a higher proportion of clinical depression cases than the vascular stroke group. Patients with functional stroke symptoms reported the highest rate of “damage beliefs” and “all-or-nothing” behaviors and greater symptom focusing and resting behavior 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 and behaviors, as well as higher rates of clinical anxiety. Understanding such group differences provides some insights into aetiology and cognitive-behavioral responses. Appropriate support and referral should be available to patients with functional stroke symptoms to address distress and reduce the likelihood of severe impairment.

AB - 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 56 patients with functional stroke symptoms were age-gender matched to patients with vascular stroke and CFS. Analysis of variance compared groups on cognitive and behavioral 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 than the CFS group, and a higher proportion of clinical depression cases than the vascular stroke group. Patients with functional stroke symptoms reported the highest rate of “damage beliefs” and “all-or-nothing” behaviors and greater symptom focusing and resting behavior 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 and behaviors, as well as higher rates of clinical anxiety. Understanding such group differences provides some insights into aetiology and cognitive-behavioral responses. Appropriate support and referral should be available to patients with functional stroke symptoms to address distress and reduce the likelihood of severe impairment.

KW - case-control

KW - cognition

KW - functional neurological conditions

KW - psychology

KW - stroke

UR - https://www.scopus.com/pages/publications/85115909347

U2 - 10.1027/2512-8442/a000093

DO - 10.1027/2512-8442/a000093

M3 - Article

AN - SCOPUS:85115909347

SN - 2512-8442

VL - 29

SP - 145

EP - 155

JO - European Journal of Health Psychology

JF - European Journal of Health Psychology

IS - 3

ER -