Post-Stroke Depression: Can Prediction Help Prevention?
Depression is common after stroke. Post-stroke depression (PSD) is an independent predictor of poor long-term functional outcome following stroke. PSD has been associated with poor social and rehabilitation outcomes, cognitive impairment and increased mortality. Prevalence varies widely between studies because of differences in patient selection, time, evaluation methods and diagnostic criteria. Approximately a third of stroke survivors may suffer from PSD. Potential confounders include anosognosia, apathy and emotional lability. The identification of risk factors is important to prevent and detect PSD early, and provide appropriate interventions. PSD may be associated with restriction in social activities and dependence in activities of daily living in the chronic phase of stroke. Pharmacologic and rehabilitation strategies are needed to treat PSD. More evidence is required before recommendations can be made about the routine use of antidepressants to prevent PSD.
Stroke is a leading cause of long-term disability in adults worldwide. Cognitive, emotional and behavioral symptoms can be observed frequently in people who have suffered a stroke. Post-stroke depression (PSD) is probably the most common emotional disturbance, and the most important long-term psychosocial consequence following stroke. However, stroke affects not only stroke survivors but the whole family, and anxiety and depression are also common in caregivers of stroke patients.
In the last decade, several studies have focused on the determinants of PSD in the acute and chronic phase of stroke. The purpose of this article is to review the risk factors and the main strategies related to the treatment and prevention of PSD. Articles related to PSD were retrieved from Medline database (last entry: 1 March 2010).
Abstract and Introduction
Abstract
Depression is common after stroke. Post-stroke depression (PSD) is an independent predictor of poor long-term functional outcome following stroke. PSD has been associated with poor social and rehabilitation outcomes, cognitive impairment and increased mortality. Prevalence varies widely between studies because of differences in patient selection, time, evaluation methods and diagnostic criteria. Approximately a third of stroke survivors may suffer from PSD. Potential confounders include anosognosia, apathy and emotional lability. The identification of risk factors is important to prevent and detect PSD early, and provide appropriate interventions. PSD may be associated with restriction in social activities and dependence in activities of daily living in the chronic phase of stroke. Pharmacologic and rehabilitation strategies are needed to treat PSD. More evidence is required before recommendations can be made about the routine use of antidepressants to prevent PSD.
Introduction
Stroke is a leading cause of long-term disability in adults worldwide. Cognitive, emotional and behavioral symptoms can be observed frequently in people who have suffered a stroke. Post-stroke depression (PSD) is probably the most common emotional disturbance, and the most important long-term psychosocial consequence following stroke. However, stroke affects not only stroke survivors but the whole family, and anxiety and depression are also common in caregivers of stroke patients.
In the last decade, several studies have focused on the determinants of PSD in the acute and chronic phase of stroke. The purpose of this article is to review the risk factors and the main strategies related to the treatment and prevention of PSD. Articles related to PSD were retrieved from Medline database (last entry: 1 March 2010).
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