Published online before print March 15, 2007, doi: 10.1161/STROKEAHA.106.480434
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(Stroke. 2007;38:1425.)
© 2007 American Heart Association, Inc.
Editorials |
No Sense of Coherence
An Odd New Risk for Stroke?
From the Center for Clinical Neurosciences (M.B.), Danube University Krems, Austria; and the Department of Public Health (J.T.), University of Helsinki, Finland.
Correspondence to Michael Brainin, MD, Center for Clinical Neurosciences, Department for Clinical Medicine and Preventive Medicine, Donau-Universität Krems, Dr.-Karl-Dorrek Strasse 30, A-3500 Krems, Austria. E-mail michael.brainin@donau-uni.ac.at
Key Words: risk factors • stress • stroke epidemiology • stroke outcome
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
See related article, pages 1447–1453.
When making a diagnosis of stroke, a physician should ask the patient how he experienced his deficit. Most patients, if not impaired by speech or memory, will give a straightforward account of their surprising and miserable experience of having felt a sudden motor or sensory loss, distressing weakness, or alarming loss of vision or of coordination. Interestingly enough, many patients also include in their story why they think this has happened to them. Often they report that they had recently endured much ‘stress’, and whatever their own personal definition for this might be, it will often be connected to a life-event, such as loss of job, loss of a spouse, or any other personal unhappy (or, much more rarely, happy) event.
Although stroke physicians empathically listen to such explanations by the patient, they do not overtly take these subjective causalities as an indicator of a stroke risk. If stressful events persist, physicians might offer general advice enabling the patient to increase his empowerment such as joining self-help groups or using community support.
But ‘stress’, or rather the lack of personal and social ability to cope with it, is now about to enter the arena of major risk factors for stroke. The ability of perceiving and handling one’s own distressing events has been called ‘sense of coherence’ and was based on the observation on survivors from concentration camps who had survived retaining their senses (of coherence) and abilities (of social empowerment).1
This concept was now
Related Article:
Stroke 2007 38: 1447-1453.