Abstract WMP26: Sex Differences in the Expression of Mood Disturbances Post-Stroke

Abstract

Background and Purpose: Stroke is one of the leading causes of death and disability globally with sex specific differences in symptoms and outcomes. Approximately 30-50% of post-stroke patients have emotional and mood disturbances (e.g., anxiety, anger, irritability, aggression). Post-stroke mood disturbances may affect stroke survivors from returning to work, poorer quality of life (QOL), and stroke reoccurrence. Women experience worse outcomes compared to males following stroke (e.g., greater age of onset, stroke severity, misdiagnosis). The identification of mood disturbances as a cause of stroke is important because management may help improve QOL and recovery. The purpose of this study was to assess sex differences in expression of mood disturbances post-stroke. Methods: We conducted a scientific review of relevant literature published between 2008 and 2023 by searching PubMed and CINAHL databases using the keywords, “sex differences”, “emotion”, “anxiety”, “anger”, “irritability”, “aggression”, “stroke”, “pathophysiology” “treatment”, and “management”. Articles not pertaining to post-stroke anxiety, anger, irritability, and aggression were excluded. Results: We included 32 studies. Women were associated with higher severity of anxiety, anger, irritability, and poorer QOL when compared to men post-stroke. Positive emotions (e.g., anticipation, trust, joy) were significantly higher (p<0.001) in women, while negative emotions (e.g., disgust, fear, sadness) were significantly higher (p<0.001) in men. The pathogenesis of post-stroke mood disturbances and association to lesion locations remain uncertain. Mood disturbances may be treated or prevented by pharmacological therapy, counseling, and education. However, treatment and management are limited and not sex specific. Conclusions: Stroke survivors present with complications of mood disturbances. Women exhibit different mood disturbances than men, however treatment and management options are limited and not sex specific. This highlights the need for long-term screening of mood disturbances in the stroke population and investigation of underlying factors for sex differences.