The doctor speaks with Trevor on the ward round. She tells Trevor that the team are aware that his crying is affecting his rehabilitation. She asks Trevor what he thinks about this. Trevor tells the doctor that the worst part of it is not being able to control his crying. He finds ‘the slightest thing’ sets him off, even when he doesn’t feel that upset. He says he feels embarrassed in front of everyone on the ward.
Nursing staff have carried out a mood screening questionnaire and the doctor discusses the results of this with Trevor. (See link below.)
Patient Health Questionnaire (PHQ-9) [1] [PDF, 240KB]
Trevor’s score on the PHQ-9 falls in the range for mild depression (5-9). However, mood screening tools are not in themselves diagnostic and when asked for more information about the questions he rated as “on several days or more” they were clearly linked specifically to his crying and the effect this is having on his progress.
For more information on mood screening view the Topic loop which can be found below. See Additional Information box below for more information on the PHQ-9.
Topic loop
Anxiety?
Although Trevor has some concerns about the future this is not uppermost in his mind and he is more focused on his crying. There is no evidence of general anxiety.
Emotional lability?
The severity of emotional outbursts are out of proportion to Trevor’s reported feelings associated with the trigger. In addition he reports no control over his crying. This strongly suggests the presence of emotional lability.
Depression?
Although Trevor scores in the mild range on a depression screening questionnaire his responses are specifically linked to his crying. He shows no other major symptoms of depression.
Common emotional response?
Although people may often feel upset or low after a stroke the severity of Trevor’s emotional outbursts are above those which you would normally expect for a common emotional response.
Physical problem?
There is no evidence of any physical causes such as infection or incontinence that may be affecting Trevor’s mood.
Page last reviewed: 21 Feb 2020
