Time-Varying Effects of Psychological Distress on the Functional Recovery of Stroke Patients

Objective To explore the temporal effects of psychological distress on the functional recovery of stroke survivors. Design A longitudinal follow-up study. All participants were interviewed at 5 days after stroke onset, and at 1, 2, 3, and 6 months after discharge from acute care hospitals. Setting Neurology inpatient and outpatient departments and rehabilitation clinics. Participants First-time stroke participants (N=62) without cognitive impairment, psychiatric disorders, or cancer were recruited. Interventions Not applicable. Main Outcome Measures Measurements consisted of demographic characteristics, disease severity, social support, the Chinese version of the Emotional and Social Dysfunction Questionnaire (ESDQ_C), and the Barthel Index. Results Our findings showed that psychological distress had a dynamic effect on functional recovery over time, and as the total ESDQ_C score increased by 1 point, the concurrent functional recovery decreased by .23 points (P<.001). Additionally, 5 subscales of the ESDQ_C including anger, emotional dyscontrol, helplessness, indifference, and euphoria also had dynamic effects on functional recovery over time (P<.05). Regardless of when a single form or various forms of psychological distress occurred over time from stroke onset, the functional recovery over time was simultaneously affected. Conclusions The time-varying effect of psychological distress on functional recovery was significant. Adopting comprehensive instruments and regular assessments for the early detection of various psychological distresses while under clinical care is needed. Effective interventions targeting both physical and mental functions would further improve the functional recovery and overall health of stroke patients.