Download Holden 2015 - King`s College London

The relationship between subjective cognitive complaints and mental health in
stroke patients, as assessed by iPad administered self-report measures.
Francesca Holden, Submitted for iBSc research project, 2015
Background: Assessing self-reported mental health in stroke remains a huge challenge due to the overlap of
cognitive and affective symptoms. Past literature describes an association between Subjective Cognitive
Complaints (SCCs) and affective symptoms. This study aims to (1) identify a self-report measure of cognitive
function, which can be administered via an iPad, (2) establish the acceptability of measuring self-reported
cognitive function in stroke patients, via an iPad and (3) explore the relationship between SCCs and affective
symptoms.
Method: Design. (1) Literature review, (2) Content analysis and (3) Cross-sectional observation. Sample. 15
patients previously discharged from a Hyper-Acute Stroke Unit (HASU) at King’s College Hospital. Patients
completed an iPad-administered, carefully selected self-report measure of SCCs, the Checklist for Cognitive and
Emotional Consequences following Stroke (CLCE-24). Patients were asked questions about the iPad administered
CLCE-24 to assess its acceptability. CLCE-24 scores were analysed with scores from the routinely administered
Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder Assessment (GAD-7) to examine the
association between SCCs and depression/anxiety levels in HASU patients.
Results: A moderately strong positive correlation was found between depression and CLCE-24 scores (.51),
however this did not reach a level of statistical significance (p<.053). There was no association between anxiety
and CLCE-24 scores (p<.64). Multiple regression analysis revealed no significant association between additional
predictor variables, such as age, gender and Stroke Impact Scale scores, and depression/anxiety scores.
However, after controlling for the effects of these additional variables, CLCE-24 score was a statistically
significant predictor of depression (p<.011), but not a statistically significant predictor of anxiety (p<.659).
Conclusion: Overall, results suggest that SCCs are associated with higher levels of depression in HASU patients.
There was no statistically significant association between SCCs and anxiety levels in these patients. Replication
with a larger sample size is required to strengthen the confirmation of these findings, as the small sample size in
this study (N=15) is likely to have limited levels of significance. Post-stroke mood disorders are a major concern
and have a high impact on patient’s quality of life and therefore effective screening is vital. IPads may improve
screening for post-stroke affective disorders to provide earlier diagnosis.
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