[Post-stroke-depression. Algorithm for a standardized diagnostic approach in clinical routine].
Depression is a frequent and important complication after stroke. The occurrence of a post-stroke-depression (PSD) has a significant impact on the functional and cognitive deficit, on mortality and on quality of life after stroke. In contrast to the clinical importance, PSD is often ignored in routine management of stroke patients and remains often untreated if diagnosed. The diagnostic uncertainty is aggravated by the lack of appropriate diagnostic criteria for PSD in the International Classification of Diseases (ICD-10) used in Germany. For the first time, we present an algorithm, which allows for a standardized examination of stroke patients on the presence of PSD. All stroke patients should be examined initially by a short and simple screening tool and are subjected to more extensive procedures only if PSD is assumed based on the screening result. Furthermore potentials and limitations to convert the diagnosis of PSD into a diagnostic related group (DRG) that is used to calculate the hospital's reimbursement are highlighted. Finally pharmacological treatment options for PSD are discussed.
Dohmen
C
C
Klinik und Poliklinik für Neurologie der Universität zu Köln, Max-Planck-Institut für neurologische Forschung, Köln. chris@pet.mpin-koeln.mpg.de
Garlip
G
G
Sitzer
M
M
Siebler
M
M
Malevani
J
J
Kessler
K R
KR
Huff
W
W
D000465:Algorithms; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D006801:Humans; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000150:complications / Q000523:psychology*