Case Report

Emotional adjustment after stroke: The role of early neuropsychotherapeutic interventions in patients following brain damage

Klaus R.H. von Wild, MD, PhD, Prof. Hon. Caus., Dr. Hon Caus., Birgit Kemper, PhD
Jpn J Compr Rehabil Sci 2: 42-47, 2011

Objective: Post-stroke depression has been considered the most common neuropsychiatric consequence of stroke, even in the presence of successful neurological recovery and good health-related quality of life. This report describes a patientfs catastrophic reactions to his unexpected illness, with a focus on the therapeutic process, to provide an understanding of managing denial and how to approach and engage brain-damaged patients.
Methods: This is a case study of a 65-year-old businessman with mental-cognitive and behavioral impairments following hypertensive cerebellar massive hemorrhage and secondary hydrocephalus, who made a complete recovery following psychotherapeutic intervention.
Results: Our supportive psychotherapeutic approach combined with cognitive interventions enabled this patient overcome moderate mental-cognitive and behavioral deficits and extreme defensive coping strategies, and facilitated his successful social re-entry.
Conclusions: Brain-damaged patients with preserved self-awareness and a high level of independence in activities of daily living (ADL), who do not have preexisting psychiatric conditions, can benefit from individualized psychotherapy over time. Attention needs to be focused on a recovery beyond functional outcomes, with an understanding of holistic neurorehabilitation as a method of reconstructing lives within a social context. Further research and education is needed for the development of proper psychotherapeutic approaches to address aspects such as emotional coping and finding sense in life following brain damage.

Key words: post-stroke depression, mood disorders, psychotherapy, neurorehabilitation

Contents (volume 2)