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TEARS: a longitudinal investigation of the prevalence, psychological associations and trajectory of poststroke emotionalism
  1. Niall McIntyre Broomfield1,
  2. Robert West2,
  3. Mark Barber3,
  4. Terence J Quinn4,
  5. David Gillespie5,
  6. Matthew Walters4,
  7. Allan House6
  1. 1Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
  2. 2University of Leeds Faculty of Medicine and Health, Leeds, UK
  3. 3Monklands Hospital, Airdrie, UK
  4. 4Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
  5. 5Department of Clinical Neurosciences (DCN), NHS Lothian, Edinburgh, UK
  6. 6University of Leeds, Leeds, UK
  1. Correspondence to Professor Niall McIntyre Broomfield, Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich NR4 7TJ, UK; N.Broomfield{at}


Objective There are few longitudinal studies of poststroke emotionalism (PSE) and our understanding of the psychological associations of PSE is limited, constraining assessment of existing interventions and the development of new therapies. This study aimed to assess the prevalence and course of PSE over the first year poststroke, and its psychological associations.

Methods Consenting stroke survivors who were physically and cognitively able to participate were assessed within 2 weeks, 6 and 12 months of stroke to determine PSE point prevalence using a diagnostic, semistructured PSE interview (Testing Emotionalism After Recent Stroke-Diagnostic Interview). At the same assessments, neuropsychological and disability status were determined using Hospital Anxiety and Depression Scale, Abbreviated Mental Test, National Institute of Health Stroke Scale, Barthel Index and Euro-Qol.

Results Two hundred and seventy seven stroke survivors were recruited between 1 October 2015 and 30 September 2018. Diagnostic data were available at baseline for 228 of 277 cohort participants. Point prevalence for PSE was 27.2% at 2 weeks; estimated prevalence at 6 months adjusted for baseline was 19.9% and at 12 months 22.3%. PSE was associated with symptoms of anxiety and event-related distress.

Interpretation PSE affects at least one in five stroke patients acutely following their stroke, and continues to affect one in eight longer term. PSE is associated with anxiety and event-related distress but is not simply a manifestation of mood disorder over time. Such psychological correlates may have implications for longer term social rehabilitation.


Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Twitter @DrTerryQuinn

  • Contributors NMB (CI), AH, DG and MW conceived and designed the study, sought and achieved study funding and worked to develop the diagnostic methods. NMB and MW oversaw all aspects of trial design, recruitment, delivery and close out Broomfield and Quinn cowrote the study protocol. TJQ and MB led/supported recruitment at key sites West progressed all data analyses. All coauthors contributed to manuscript drafting and revision. NMB is the author responsible for the overall content as the guarantor.

  • Funding Stroke Association, UK (TSA 2013/03).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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