Assessment and Approach to Treatment in Post‐Stroke Depression

Abstract

Recent research indicates that post-stroke depression results from neurobiological changes associated with focal cerebral injury. Family or medical personnel may identify potential depression. An accurate assessment process will determine the extent of depression and indicate treatment options. Treatment approaches using both medication and cognitive therapy can help the individual replace negative thinking patterns with positive patterns. Depression has been accepted as a normal accompaniment of stroke. The area of injury may correlate with the degree of mood disorder. Interventions to reverse depression will serve to improve rehabilitation potential and increase chances of recovering pre-stroke capabilities.

Pathophysiology and Current Drug Treatments for Post-Stroke Depression: A Review

“…The abnormal neurotropic responses caused by glutamate-mediated excitotoxicity increase due to the cytokines produced after stroke. The following complex processes, including the enlargement of cerebral infarctions due to neuronal death and hypercortisolism, can induce stress [ 51 ]. Moreover, inflammation that often occurs post-stroke reduces intercellular serotonin transporters, thus increasing the risk of depression and associated symptoms.…”

Nursing Assessment of Depression in Stroke Survivors

“…16–18 However, the plethora and length of various screening and diagnostic tools available has made it hard to know which instruments are both efficient and accurate in detecting depressive symptoms, particularly in the face of medical illness. More recently a variety of screening instruments used with stroke patients have been evaluated against each other and against the reference standard of clinical interview.…”

Relation Between Post Stroke Depression (PSD) and CT- Scan and MRI Findings and Estimation of Functional Degradation in Patients 2-7 Months after Stroke

“…Journal of Complementary Medicine & Alternative Healthcare group, history of depression and stroke and being alone are related to PSD. The most likely occurrence of depression occur in the first 2 years after stroke and its pick is in the first 3 to 6 months [6][7]. Some of studies have suggested depression as the main cause of death in stroke patients.7 Also female gender , age less than 60 years old , live alone, divorce, alcoholism , inability to return to work, decreased social activity , change in communication with others and size of brain lesions are the risk factors for post stroke depression [4,[6][7].…”

“…The most likely occurrence of depression occur in the first 2 years after stroke and its pick is in the first 3 to 6 months [6][7]. Some of studies have suggested depression as the main cause of death in stroke patients.7 Also female gender , age less than 60 years old , live alone, divorce, alcoholism , inability to return to work, decreased social activity , change in communication with others and size of brain lesions are the risk factors for post stroke depression [4,[6][7]. Studies have shown that the use of antidepressants has reduced the incidence of stroke complications and improved its outcome.…”

“…Studies have shown that the use of antidepressants has reduced the incidence of stroke complications and improved its outcome. Therefore, timely diagnosis of depression and quick actions in its treatment are effective in reducing recurrence of stroke, mortality and improving the quality of life of patients [6,8]. Considering the importance of post stroke depression in the prognosis of patients and its mortality and also considering the burden of disease, the aim of this study was to investigate the relation between PSD and CT-scan and MRI findings and estimation of functional degradation in patients 2 to 7 months after stroke.…”