Poststroke depression

Aust Fam Physician. 2004 Oct;33(10):831-4.

Abstract

Background: Poststroke depression (PSD) is common and often unrecognised. The diagnosis can be difficult due to deficits of stroke such as impaired self reporting and cognition, poor insight and dysphasia. Untreated PSD can interfere with recovery and adversely affect functional and social outcomes.

Objective: This article outlines the diagnosis, pathophysiology and treatment for PSD.

Discussion: The natural history of PSD suggests that most PSD is not immediate but develops over months with peak prevalence between 6 and 24 months, and in some cases persists up to 3 years following stroke. General practitioners and treating specialists need to actively monitor patients for PSD. While antidepressant medication is the mainstay of treatment for PSD, psychotherapeutic interventions are important. Treatment should include patient and family education, reestablishment of sleep pattern, addressirng functional difficulties, increasing community participation, improving diet and regular exercise.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / etiology
  • Depressive Disorder, Major* / physiopathology
  • Humans
  • Patient Education as Topic
  • Psychological Tests
  • Psychosocial Deprivation
  • Stroke / complications*
  • Stroke Rehabilitation

Substances

  • Antidepressive Agents