Psychiatric Comorbidity and Quality of Life in Patients with Post-Stroke Emotional Incontinence

OBJECTIVE: We aimed to investigate the associations of post-stroke emotional incontinence (PSEI) with various psychiatric symptoms and quality of life independent of potential covariates in survivors of acute stroke. METHODS: A total of 423 stroke patients were assessed within 2 weeks of the index event. Psychiatric symptoms were assessed by the Symptom Checklist-90-Revised (SCL-90-R), which has nine domains comprising Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychoticism. Quality of life was measured using the World Health Organization Quality of Life abbreviated form (WHOQOL-BREF), which has four domains related to physical factors, psychological factors, social relationships, and environmental context. Associations of PSEI with scores on the SCL-90-R and WHOQOL-BREF were investigated using pairwise logistic regression model adjustment for potential sociodemographic and clinical covariates. RESULTS: PSEI was present in 51 (12.1%) patients. PSEI was associated with the Obsessive-Compulsive, Interpersonal Sensitivity, and Hostility symptom dimensions of the SCL-90-R and with the psychological factors and social relationships domains of the WHOQOL-BREF independent of important covariates including previous stroke, stroke severity, and physical disability. CONCLUSION: PSEI causes some aspects of psychiatric distress and negatively affects psychological and interpersonal quality of life. For patients with PSEI, special attention to psychiatric comorbidity and quality of life is needed, even in the acute stage of stroke.

A Case of PANDAS with Emotional Lability / 신경정신의학

The authors report a case of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) and emotional lability. This is a 12-year-old girl who developed normally until the age of 11, when she had a high fever with headache followed by abnormal tic movement, emotional lability, ands high antistreptolysin-O (ASO) titer. The case illustrates difficulties in diagnosing and treating the PANDAS.