Posted by Kostas Pantremenos in Depression on March 20, 2022
Background: Depression is very common in patients after a stroke and it can impact recovery.
Objective: The Cochrane Review aimed to determine whether psychological therapy, pharmacological interventions, non-invasive brain stimulation, or their combination can prevent depression after stroke.
Methods: The population addressed were patients who suffered from a stroke and had no previous diagnosis of depressive disorders. Studies comparing pharmacological intervention to placebo, psychological therapy to usual care, and non-invasive brain stimulation to sham stimulation or usual care were included.
Results: Outcome information was available for nine pharmacological and two psychological trials, showing favorable treatment effects.
Conclusions: The available evidence suggests that pharmacological interventions and psychological therapy may prevent depression and improve mood after stroke. Although, the current evidence is of very low quality resulting in serious uncertainties about the estimates of effect observed.
Posted by Kostas Pantremenos in Uncategorized on February 8, 2022
Posted by Kostas Pantremenos in TBI on September 25, 2020
Traumatic brain injury (TBI) can significantly affect many cognitive, physical, and psychological skills. Physical deficit can include ambulation, balance, coordination, fine motor skills, strength, and endurance. Cognitive deficits of language and communication, information processing, memory, and perceptual skills are common. Psychological status is also often altered. Adjustment to disability issues are frequently encountered by people with TBI.
Brain injury can occur in many ways. Traumatic brain injuries typically result from accidents in which the head strikes an object. This is the most common type of traumatic brain injury. However, other brain injuries, such as those caused by insufficient oxygen, poisoning, or infection, can cause similar deficits.
Mild Traumatic Brain Injury (MTBI) is characterized by one or more of the following symptoms: a brief loss of consciousness, loss of memory immediately before or after the injury, any alteration in mental state at the time of the accident, or focal neurological deficits. In many MTBI cases, the person seems fine on the surface, yet continues to endure chronic functional problems. Some people suffer long-term effects of MTBI, known as postconcussion syndrome (PCS). Persons suffering from PCS can experience significant changes in cognition and personality.
Most traumatic brain injuries result in widespread damage to the brain because the brain ricochets inside the skull during the impact of an accident. Diffuse axonal injury occurs when the nerve cells are torn from one another. Localized damage also occurs when the brain bounces against the skull. The brain stem, frontal lobe, and temporal lobes are particularly vulnerable to this because of their location near bony protrusions.
The brain stem is located at the base of the brain. Aside from regulating basic arousal and regulatory functions, the brain stem is involved in attention and short-term memory. Trauma to this area can lead to disorientation, frustration, and anger. The limbic system, higher up in the brain than the brain stem, helps regulate emotions. Connected to the limbic system are the temporal lobes which are involved in many cognitive skills such as memory and language. Damage to the temporal lobes, or seizures in this area, have been associated with a number of behavioral disorders. The frontal lobe is almost always injured due to its large size and its location near the front of the cranium. The frontal lobe is involved in many cognitive functions and is considered our emotional and personality control center. Damage to this area can result in decreased judgement and increased impulsivity.
Conditions and Other Information
Posted by Kostas Pantremenos in Disability and Sex, TBI on August 5, 2020
Posted by Kostas Pantremenos in Depression, Paretic Hand on January 1, 2018
The primary purpose of this scoping review was to describe the nature and extent of the published research that assesses the relationship between psychological features and patient-reported outcome following surgery or rehabilitation of upper extremity disease or injury.
Twenty-two included studies were examined for quantitative study design, outcome measure, inclusion/exclusion criteria, follow-up and recruitment strategy. Patient population and psychological assessment tools were examined for validity.
Twenty-two studies met the inclusion criteria for this study. Only 7 of the 22 studies were longitudinal and the rest were cross sectional studies. Depression was the most common psychological status of interest and was included in 17 studies. Pain catastrophizing was the psychological status of interest in 5 of the studies. Four studies considered anxiety, 3 considered pain anxiety, 3 considered distress, 2 considered coping, 2 considered catastrophic thinking, and 2 considered fear avoidance beliefs.
The majority of studies in this review were cross-sectional studies. Cross-sectional studies may not provide conclusive information about cause-and-effect relationships. This review encourages clinicians to be mindful of the psychological implications found in rehabilitation of individuals with upper extremity disease or injury along with being cognizant of choosing appropriate measurement tools that best represent each patient’s characteristics and diagnoses.
The nature of the research addressing psychological factors affecting outcomes after hand injury focus on negative traits and have limited strength to suggest causation as most have used cross-sectional designs. Stronger longitudinal designs and consideration of positive traits are needed in future studies.
Posted by Kostas Pantremenos in Uncategorized on March 1, 2017
Systematic review.
After traumatic hand injury, extensive physical and psychological adaptation is required following surgical reconstruction. Recovery from injury can understandably be emotionally challenging, which may result in impaired quality of life and delayed physical recovery. However, the evidence base for identifying high-risk patients is limited.
A PROSPERO-registered literature search of MEDLINE (1946-present), EMBASE (1980-present), PsychInfo, and CINAHL electronic databases identified 5156 results for studies reporting psychological outcomes after acute hand trauma. Subsequent review and selection by 2 independent reviewers identified 19 studies for inclusion. These were poor quality level 2 prognostic studies, cross sectional or cohort in design, and varied widely in methodology, sample sizes, diagnostic methods, and cutoff values used to identify psychological symptoms. Data regarding symptoms, predisposing factors, and questionnaires used to identify them were extracted and analyzed.
Patients with amputations or a tendency to catastrophize suffered highest pain ratings. Persisting symptom presence at 3 months was the best predictor of chronicity. Many different questionnaires were used for symptom detection, but none had been specifically validated in a hand trauma population of patients. Few studies assessed the ability of selection tools to predict patients at high risk of developing adverse psychological outcomes.
Despite a limited evidence base, screening at 3 months may detect post-traumatic stress disorder, anxiety, depression, and chronic pain, potentially allowing for early intervention and improved treatment outcomes.
Posted by Kostas Pantremenos in Books, REHABILITATION on October 10, 2016
Health and well-being is best understood in terms of a combination of biological, psychological, and social factors. But how ‘social’ is the biopsychosocial model when applied to mental health and rehabilitation? Psychology has traditionally viewed health as being determined by individual behavior. An integrative psychological approach is required to draw understanding from sociology, social psychology, and politics to consider how wider systemic, structural, and contextual factors impact on health behavior and outcomes. This e-book is dedicated to examining collective and community approaches to well-being and rehabilitation. In particular, the articles contained within this e-book are seeking to understand how social integration, social groups, social identity, and social capital influence health, well-being, and rehabilitation outcomes.
TBI Rehabilitation 