VARANASI: Taking care of trauma and depression is the key for treatment and rehabilitation of stroke patients, who undergo various levels of stress after facing cognitive deficits, believes Dr Uday Sinha, additional professor, Department of Clinical Psychology, Institute of Behaviour and Allied Sciences (IBAS), New Delhi. He believes that neuro-psychological issues should not be overlooked while treating stroke patients, as the move could backfire and hamper the chances of success.

Highlighting the neuro-psychological issues in stroke patients on the concluding day of two-day symposium on stroke, organised by Department of Neurology, Banaras Hindu University on Sunday, Dr Sinha said that about 66 percent (two-third) of stroke survivors have cognitive problems after stroke that leads to cognitive impairment. In addition, one-third of these patients develop dementia in the due course of treatment. It is therefore important to identify post stroke cognitive impairment including personality disorder, problems in memory sequencing, attention deficit, problems in making judgments and general orientation along with declining problem solving abilities, he added on the occasion.

Saying that various tools and detection techniques could help identify cognitive impairment in early stages, the neuro-psychological expert stressed that the process starts from observations including keeping eye on interactions and speech of such patients. Similarly, screening tests are conducted to gauge the orientation and memory skills of the patients. One also needs to remember that impact of cognitive impairment is reflected in activities of daily living (ADL), adjustments, personal and occupational functioning along with social and interpersonal relationship, he said.

It may be mentioned here that while physical disabilities attract attention in the course of treatment, cognitive impairment and psychological stress are often overlooked that not only prolongs the treatment period but also results in poor and delayed response.

According to Dr Sinha, the treatment of stroke patients require multi-disciplinary approach and management of emotional and behavioural disturbances is the key to successful treatment and rehabilitation. Around 20 percent of stroke patients have major depression and other 20 to 25 percent have mild depression. The stroke often brings risk for psychiatric disorders and post-stroke depression cause general anxiety disorders. The emotional reaction transform into shock and fear and if not managed properly, it could deteriorate into disorganization, despair, exhaustion and burn out cases, which are extreme form of stress and depression.

Interestingly, the mental health of caregivers directly affect recovery of stroke patient and management of caregivers psychological disturbances also becomes important in this aspect. It needs proper tracking of caregivers emotional expression and behaviour to identify disturbances and demands regular supportive counselling sessions, added Dr Sinha on the occasion.