Psychometric evaluation of a newly developed measure of emotionalism after stroke (TEARS-Q).

The questionnaire was validated only in 224 people without aphasia who completed it within 2 weeks of stroke, so it may not work for people with language problems, severe distress, or later after stroke. Most participants were from West of Scotland, were relatively young, and had mild stroke, so the results may not apply to other cultures, older people, or the full stroke severity range. The reference standard was a diagnostic interview developed by the authors, not an independent published schedule, and nurses had clinical information while delivering the assessments on the same day. The study did not show that TEARS-Q is stable over time or sensitive to change, which matters for monitoring treatment. TEARS-Q only measures crying, not uncontrollable laughter, and positive and negative predictive values apply only to the acute stroke phase. The two-item screen stopped 82.1% of people without emotionalism, compared with 90% for the full questionnaire.

The study was funded by Stroke Association UK and sponsored by NHS Greater Glasgow and Clyde, which held responsibility for its integrity and conduct. The authors declared no potential conflicts of interest.

Do not read a TEARS-Q score of 2 or more as a diagnosis of emotionalism for every stroke patient. It was validated only in people without aphasia within 2 weeks of stroke, and its accuracy depends on comparison with an interview developed by the authors.