[Post-stroke depression].
In recent years, post-stroke depression (PSD) has attracted a worldwide interest. This review addresses the major research issues of PSD. PSD is the most frequent psychic complication among stroke survivors. Depression has a significant impact on post-stroke recovery and mortality. The diagnosis of PSD is based on the structured mental state examination and DSM-IV criteria as well as on the scores of the clinical symptoms scale (the Hamilton Depression Rating Scale) and self-rated inventories. PSD is multifactorial in origin and develops under the influence of biopsychosocial factors. The anatomical correlates of PSD change over time. In acute stage and 3-6 months after stroke, depression is associated with left-hemisphere lesion severity and proximity of the lesion to the frontal pole and related to the dysfunction of (cortico-) striato-pallido-thalamic-cortical projections. In post-stroke period (1-2 years) depression is significantly associated with right-hemisphere lesion severity and proximity of the lesion to the occipital pole. The most relevant psychosocial risk factors for PSD are described as follows: past history of depression and other mental disorders, dysphasia, functional impairment, living alone and post-stroke social isolation. Selective serotonin reuptake inhibitors (citalopram and fluoxetine) may be effective in the treatment of PSD.
Levada
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Slivko
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D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D020521:Stroke / Q000150:complications*