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Stroke represents the third most frequent cause of mortality in developed countries, following only coronary heart diseases and cancer. Post-Stroke Depression (PSD) is extremely common among stroke survivors, and it may have great burden on the likelihood of functional recovery and long-term outcomes. We hypothesized that PSD is related to a higher rate of mortality among people suffering from a stroke.
To estimate the risk of mortality among subjects suffering from PSD as compared with stroke survivors who did not suffer from PSD.
We performed a systematic review of papers indexed in Pubmed. Both fixed and random-effects methods for estimating association and time-to-event pooled effects were used. The presence and the level of heterogeneity were assessed using Q test and I2 statistic.
Seven papers had data suitable for meta-analysis. The pooled association effect for mortality at follow-up in people with PSD were statistically significant (p< 0.05). The time-to-event estimation showed a statistically significant correlation exclusively under the fixed effect analysis.
These findings pointed out the potential burden of PSD on post stroke mortality. Further investigation is required to clarify the nature of PSD/mortality association.
Schizophrenia (SKZ) is a disease characterized by positive and negative symptoms, thoughts and behaviour disorganization with a progressive socio-cognitive impairment1; deficits in facial emotion recognition (FER) represent one of the most serious problems linked to interpersonal problems2. In addition, these patients have often comorbid condition of alcohol and substances abuse3.
to compare the ability of FER in patients with SKZ using alcohol and/or substances (SKZ+SUD) compared to schizophrenics without SUD (SUD-SKZ).
we enrolled 53 subjects (M=40, F=13) with a DSM-IV diagnosis of SKZ (SCID I). The sample was divided according to alcohol and/or substance abuse (AUS and DUS) into two groups, compared for socio-demographic and clinic characteristics (PANSS and Bell model4). We analyzed the association between abuse condition and Ekman test performance.
SKZ+SUD (n=20; M=16, F=4) and SKZ-SUD (n=33; M=24, F=9) show a statistically significant age difference with a mean (SD) of 38.4 years (10.5) and 46.0 years (8.7) respectively (p=0.006). SKZ+SUD Ekman test score (mean=43.1, SD=6.9) was statistically higher (p=0.006) than SKZ-SUD (mean=34.6, SD=12.0). The different performance was more evident in comparison with poly-abusers (44.94±7.05 vs 12.04±34.6; p=0.002). We further noticed the role of disorganization as a mediator of the relationship between abuse and FER score (p=0.017): the proportion of the effect of abuse on Ekman test score was 48%.
In subjects with SKZ, FER seems to be less impaired in abusers than non-abusers. We also showed an important role of thoughts and behavioral disorganization as a mediator between SKZ+SUD and FER.
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