J Neuropsychiatry Clin Neurosci 1993; 5:189-194
Copyright © 1993 by American Neuropsychiatric Association
Catastrophic reaction after cerebrovascular lesions: frequency, correlates, and validation of a scale
SE Starkstein, JP Fedoroff, TR Price, R Leiguarda and RG Robinson
Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The frequency and correlates of the catastrophic reaction (CR) were
examined in 52 consecutive patients with an acute stroke lesion. A new
scale proved reliable for measuring the severity of CR. The CR was
significantly associated with depression, a personal and family history of
psychiatric disorder, and subcortical lesions, which were mostly located in
the basal ganglia. Patients with and without a CR, when matched for the
presence and type of depression, differed only in that CR patients had
significantly more anterior lesions and a significantly higher frequency of
subcortical damage. Results demonstrate that the CR is significantly
associated with poststroke depression and may be a specific manifestation
of certain types of poststroke depression.
