Post-stroke depression: an update.
BACKGROUND
Post-stroke depression (PSD) is the most common mood disorder following a stroke, and also the main factor limiting recovery and rehabilitation in stroke patients. In addition, it may increase mortality by up to ten times.


METHODS
PSD occurs in 1 in 3 stroke patients and more than half of all cases are neither diagnosed nor treated. Several mechanisms, including biological, behavioral, and social factors, are involved in its pathogenesis. Symptoms usually occur within the first three months after stroke (early onset PSD), and less frequently at a later time (late onset PSD). Symptoms resemble those of other types of depression, although there are some differences: PSD patients experience more sleep disturbances, vegetative symptoms, and social withdrawal. For PSD diagnosis, we recommended vigilance and use of specific diagnostic tools such as the Patient Health Questionnaire-2 (PHQ-2). The treatments of choice are selective serotonin reuptake inhibitors (SSRI). However, there are still many unanswered questions in the treatment of PSD, such as the best time to start treatment or the effects of antidepressants on cognition and motor function, among others.


CONCLUSIONS
Neurologists play a pivotal role in the care and management of patients recovering from stroke. They must be familiar with methods for early detection and treatment of PSD, as this can facilitate a patient's functional recovery and social reintegration, and improve quality of life for patients and their families.
Servicio de Psiquiatría, Hospital de la Merced, Osuna, Sevilla, España.
G
G
Espárrago Llorca
Servicio de Medicina Interna, Hospital de la Merced, Osuna, Sevilla, España.
L
L
Castilla-Guerra
Servicio de Neurología, Hospital de Valme, Sevilla, España. Electronic address: castillafernandez@hotmail.com.
M C
MC
Fernández Moreno
Servicio de Psiquiatría, Hospital de la Merced, Osuna, Sevilla, España.
S
S
Ruiz Doblado
Servicio de Neurología y Neurofisiología, Hospital Virgen del Rocío, Sevilla, España.
M D
MD
Jiménez Hernández
D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D020521:Stroke / Q000523:psychology*; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors