The psychological burden of “mild” aphasia: Greater associations with psychosocial well-being than with language severity

Objectives: Depression is common following stroke and neural injury, and individuals who develop aphasia—a language disorder—face an increased risk. However, people with aphasia are rarely assessed, referred, or treated for post-injury depression, an issue that may be further exacerbated in mild cases that lead to direct discharge home. Here, we examined the prevalence and correlates of depression in a cohort characterized, on average, by very mild or “latent” aphasia. Methods: Using the Patient Health Questionnaire (PHQ-9) and the Western Aphasia Battery (WAB), we investigated relationships between depression and aphasia in 79 individuals with and 73 individuals without aphasia. Subgroup analyses investigated (a) sentiment in response to the open-ended question “How do you think your speech is these days?” and (b) self-reported psychosocial quality of life (Stroke Aphasia Quality of Life; SAQOL-39). Results: Individuals with aphasia showed higher rates of depression than neurologically healthy peers. Depression severity did not relate to aphasia severity. However, depression severity did relate to (a) the emotional valence of participants’ descriptions of their speech, (b) younger age, and (c) poorer psychosocial quality of life. Conclusions: These findings indicate that depressive symptoms are elevated even among individuals with very mild aphasia, and are more closely associated with younger age, negative valence about speech, and poorer psychosocial quality of life than with objectively measured aphasia severity. This underscores the importance of assessing the lived impact of communication changes across the full spectrum of post-injury aphasia.