Deans' stroke musings: Early screening for emotional and cognitive issues may improve psychiatric outcomes for stroke patients

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, June 22, 2025

Early screening for emotional and cognitive issues may improve psychiatric outcomes for stroke patients

Survivors would rather you prevent these psychiatric outcomes by having 100% recovery protocols! Are you that blitheringly stupid you don't realize what survivors want? This research would be totally unnecessary if you got 100% recovery protocols completed!

Early screening for emotional and cognitive issues may improve psychiatric outcomes for stroke patients

byPaary BalakumarandAlex Chan

June 20, 2025

in Neurology, Psychiatry

Reading Time: 2 mins read

1. Routine single-session screening for emotional and cognitive issues post-stroke does not improve long-term societal participation but may offer modest early benefits in anxiety and quality of life

Evidence Rating Level: 1 (Excellent)

The ECO-stroke trial, a multicenter, cluster-randomized controlled study, evaluated whether structured screening and care for emotional and cognitive problems at 6 weeks post-ischemic stroke improves societal participation at one year. Conducted across 12 Dutch hospitals, 531 patients discharged home without inpatient rehabilitation were enrolled. Intervention patients received a 1-hour nurse-led consultation including standardized screening tools (CLCE-24, MoCA, HADS), self-management support, and referrals as needed. The primary outcome—societal participation at one year measured via USER-P-R—did not significantly differ between intervention and usual care groups (mean difference [MD] 0.77; 95% CI −2.47 to 4.06; p=0.652). However, secondary outcomes at 3 months showed modest improvements favoring the intervention group: reduced anxiety symptoms (HADS-A MD −0.86), improved quality of life (EQ-5D-5L MD 0.044; EQ-VAS MD 2.9), and greater self-efficacy (GSES MD 0.97). These effects persisted to a lesser extent at 1 year. No significant differences were observed in cognitive or depressive symptoms, disability (mRS), or societal participation at either follow-up point. The study suggests that a single screening session may be insufficient to meaningfully impact complex outcomes like participation. Strengths include the large sample and pragmatic design; limitations include low referral rates and potential underpowering for secondary endpoints. Future analysis will assess cost-effectiveness.

Click to read the study in Neurology

Image: PD

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