
Schizophrenia is a mental health condition characterised by hallucinations, delusions, disorganised speech, and inappropriate or catatonic motor behaviour. Post-stroke psychosis is a recognised phenomenon, and can present as delusional disorder, schizophrenia-like psychosis, or mood disorder with psychotic features. However, there is no evidence to suggest that schizophrenia can cause a stroke.
Characteristics | Values |
---|---|
Prevalence | 4.86% |
Most common type | Delusional disorder |
Most common delusions | Persecutory delusions |
Most common hallucinations | Auditory |
Most common lesion location | Right hemisphere |
Most common antipsychotic medication | Haloperidol |
What You'll Learn
- Post-stroke psychosis is rare but can be caused by lesions in the right frontal, temporal and parietal regions, as well as the right caudate nucleus
- Post-stroke psychosis is more prevalent than previously recognised and is associated with a higher mortality rate
- Post-stroke psychosis is associated with poorer functional outcomes and increased mortality
- Post-stroke psychosis is more common in men than women
- Post-stroke psychosis is more likely to occur in patients with no previous psychiatric history
Post-stroke psychosis is rare but can be caused by lesions in the right frontal, temporal and parietal regions, as well as the right caudate nucleus
Post-stroke psychosis is rare, but it can be caused by lesions in the right frontal, temporal and parietal regions, as well as the right caudate nucleus. The right frontal region was affected in 11.4% of patients, the right temporal region in 9.8% of patients, the right parietal region in 15.2% of patients, and the right caudate nucleus in 5.3% of patients. The right middle cerebral artery was the most commonly affected artery, reported in 8.3% of patients.
Post-stroke psychosis is more common in men than in women, with an average age of onset of 66.6 years. The most common type of post-stroke psychosis is delusional disorder, followed by schizophrenia-like disorder and mood disorder with psychotic features. The most common delusions are persecutory delusions, followed by delusional jealousy, reduplicative paramnesia, and somatic delusions. The most common hallucinations are auditory, followed by visual.
Many patients with post-stroke psychosis have no previous psychiatric history. The most common treatment for post-stroke psychosis is antipsychotic medication, such as haloperidol and risperidone, although there are no clear guidelines on how long this treatment should be continued. The most common treatment outcome is the complete resolution of psychotic symptoms, with an average time to resolution of 3.5 months. However, long-term outcomes for patients with post-stroke psychosis are generally poor, with increased mortality and difficulty coping with the sequelae of stroke.
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Post-stroke psychosis is more prevalent than previously recognised and is associated with a higher mortality rate
Post-stroke psychosis (PSP) is a rare but serious neuropsychiatric condition characterised by delusions and/or hallucinations following a stroke. It is underdiagnosed and undertreated, with limited data on its prevalence and risk factors. However, it is more prevalent than previously recognised, affecting around 5% of stroke survivors.
A retrospective cohort study found that patients with post-stroke psychosis were 51% more likely to die during a 10-year follow-up period than those without psychosis after stroke. The most common cause of death was cardiovascular disease. Post-stroke psychosis is associated with a higher mortality rate, and patients with post-stroke psychosis had the lowest survival rate compared to stroke survivors with other psychiatric disorders.
The reasons for the increased mortality rate are currently unknown. However, it is suggested that adverse lifestyle choices and physical comorbidities, such as cardiovascular diseases, may influence the poor prognosis and higher mortality rates.
The prevalence of post-stroke psychosis was found to be 5.4% in a prospective study of 2,624 acute stroke patients. This study also identified potential risk factors, including older age, male patients, lower education level, hemiplegia, sphincter affection, cortical lesion, brain atrophy, small vessel disease, ischemic stroke, post-stroke dementia, and seizures.
Post-stroke psychosis is a significant complication that can profoundly impact the prognosis and quality of life of stroke survivors. Recognising and treating it effectively is crucial for optimising recovery and long-term outcomes.
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Post-stroke psychosis is associated with poorer functional outcomes and increased mortality
Post-stroke psychosis may have a negative effect on social and motor function, as well as on overall quality of life. These effects are independent of the primary neurologic sequelae of stroke itself and may influence rehabilitation and community reintegration efforts among stroke survivors. The most common symptoms are depression, anxiety, fatigue, and apathy; however, post-stroke psychosis is more common than originally thought and is associated with a higher mortality rate. In a retrospective cohort study of 1,008 individuals that compared case subjects with post-stroke psychosis to those without a post-stroke psychiatric disorder, the investigators found that individuals in the former group were 51% more likely to die during a 10-year follow-up period. While post-stroke psychosis is strongly associated with poor functional and mortality outcomes, more research on this entity is needed.
Compared to other stroke survivors, patients with post-stroke psychosis are more likely to depend on assistance in their everyday lives, can have more difficulty coping with the sequelae of stroke, and have an increased 10-year mortality risk. The prevalence of psychosis is high in neurocognitive disorders, at around 30% in Alzheimer’s disease, 75% in dementia with Lewy bodies, and 15% in vascular dementia. Thus, neurocognitive disorders are an important differential diagnosis for psychosis in the elderly.
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Post-stroke psychosis is more common in men than women
Post-stroke psychosis is more common in men than in women. In a review of 2442 references, 79 (46.5%) of the patients were female, and 91 (53.5%) were male. The average age of onset was 66.6 years, with a standard deviation of 16.59 years. The average time between a stroke and the onset of psychosis is estimated to be 6.1 months, but it can also occur within the first week or several months after a stroke.
Post-stroke psychosis is associated with higher mortality rates and a negative impact on social and motor function, as well as overall quality of life. The most common symptoms of post-stroke psychosis include delusions, hallucinations, and mood changes with psychotic features. The most common type of delusion is persecutory delusion, followed by delusional jealousy and reduplicative paramnesia. The most common types of hallucinations are auditory and visual.
The majority of patients with post-stroke psychosis are found to have right hemisphere lesions, particularly in the frontal, temporal, and parietal regions, as well as the right caudate nucleus. This is consistent with the notion that right hemisphere pathology is associated with perceptual anomalies and pathologies of belief. However, left hemisphere strokes, which can result in language and communication problems, may also be a factor in the development of post-stroke psychosis, as they can impede the assessment of psychosis.
The treatment for post-stroke psychosis is limited, and the most commonly used medications are antipsychotics. However, antipsychotics themselves can increase the risk of stroke. There is a need for more clinical investigations to address the pathology associated with post-stroke psychosis and to explore alternative pharmacotherapies to improve treatment efficacy and safety.
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Post-stroke psychosis is more likely to occur in patients with no previous psychiatric history
Post-stroke psychosis is associated with poor functional outcomes and high mortality. It is considered one of the most serious post-stroke syndromes. However, it has received relatively little attention in research, and there is a lack of systematic treatment studies. The most common treatment for post-stroke psychosis is antipsychotic medication, but there is a concern that this may increase the risk of stroke.
The average age for the occurrence of post-stroke psychosis is 66.6 years, and it is more common in men than in women. The most common type of post-stroke psychosis is delusional disorder, followed by schizophrenia-like psychosis and mood disorder with psychotic features. The most common delusions include persecutory delusions, delusional jealousy, reduplicative paramnesia, and somatic delusions.
The majority of patients with post-stroke psychosis do not have a previous psychiatric history. However, when it is present, alcohol misuse and depression are the most common previous psychiatric disorders. Other risk factors for post-stroke psychosis include hypertension, hyperlipidemia, and diabetes mellitus, which are also common risk factors for stroke.
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Frequently asked questions
Schizophrenia is a mental health condition and cannot physically cause a stroke. However, antipsychotic drugs used to treat schizophrenia may increase the risk of having a stroke.
Post-stroke psychosis is a rare complication of stroke. The estimated frequency of post-stroke psychosis is 4.86%.
There is a lack of evidence on the chances of having a stroke if you have schizophrenia. However, antipsychotic drugs used to treat schizophrenia may increase the risk of having a stroke.