Mental health and psychological wellbeing

3.6 Maintaining or improving mental health and psychological wellbeing should be an explicit target of intervention for people with aphasia, therefore requiring attention during goal setting.

References: Bartoli et al., 2018: Systematic review and meta-analysis of 7studies; Donnellan et al., 2010: Non-randomised observational study; Hilari et al., 2009: Qualitative study; House et al., 2001: Non-randomised observational study; Mitchell et al., 2017: Meta-analysesof 108 studies; Kauhanen et al., 2000: non-randomised observational study; Thomas & Lincoln, 2008: Non-randomised observational study; Zanella et al., 2023: Non-randomised observational study
NHMRC Level of Evidence: GPP

Rationale: Mood disorders occur frequently among stroke survivors (Campbell-Burton et al., 2012; Hackett & Pickles, 2014; Knapp et al., 2020), and those with aphasia are at particularly high risk (Hilari et al., 2009; Kauhanen et al., 2000; Mitchell et al., 2017; Thomas & Lincoln, 2008; Zanella et al., 2023).

Given the significant negative and potentially long-term effects of depression on stroke survivors (Bartoli et al., 2018; Donnellan et al., 2010; House et al., 2001), maintaining or improving psychological wellbeing should be an explicit treatment target as negotiated and agreed upon with the person with aphasia. As such, goals relating to mental health and wellbeing should be included in goal-setting discussions.

References: 

• Bartoli, F., Di Brita, C., Crocamo, C., Clerici, M. & Carrà, G. (2018). Early post-stroke depression and mortality: Meta-analysis and meta-regression. Frontiers in Psychiatry, 9(530). DOI: 10.3389/fpsyt.2018.00530
• Donnellan, C., Hickey, A., Hevey, D., O’Neill, D. (2010). Effect of mood symptoms on recovery one year after stroke. International Journal of Geriatric Psychiatry, 25(12), 1288-1295. DOI: 10.1002/gps.2482.
• Hilari, K. & Byng, S. (2009). Health-related quality of life in people with severe aphasia. International Journal of Language & Communication Disorders, 44(2), 193-105. DOI: 10.1080/13682820802008820
• House, A., Knapp, P., Bamford, J., & Vail, A. (2001). Mortality at 12 and 24 months after stroke may be associated with depressive symptoms at 1 month. Stroke, 32(2), 696-701. DOI: 10.1161/01.str.32.3.696
• Mitchell, A. J., Sheth, B., Gill, J., Yadegarfar, M., Stubbs, B., Yadegarfar, M., & Meader, N. (2017). Prevalence and predictors of post-stroke mood disorders: A meta-analysis and meta-regression of depression, anxiety and adjustment disorder. General Hospital Psychiatry, 47, 48–60. https://doi.org/10.1016/j.genhosppsych.2017.04.001
• Kauhanen, M.-L., Korpelainen, J. T., Hiltunen, P., Määttä, R., Mononen, H., Brusin, E., Sotaniemi, K. A., & Myllylä, V. V. (2000). Aphasia, Depression, and Non-Verbal Cognitive Impairment in Ischaemic Stroke. Cerebrovascular Diseases (Basel, Switzerland), 10(6), 455–461. https://doi.org/10.1159/000016107
• Thomas, S. A. & Lincoln, N. B. (2008). Predictors of Emotional Distress After Stroke. Stroke (1970), 39(4), 1240–1245. https://doi.org/10.1161/STROKEAHA.107.498279
• Zanella, C., Laures-Gore, J., Dotson, V.M., & Belagaje, S.R. (2023). Incidence of post-stroke depression symptoms and potential risk factors in adults with aphasia in a comprehensive stroke center. Topics in Stroke Rehabilitation 30(5), 448-458. DOI: 10.1080/10749357.2022.2070363