Cerebrovascular diseases and depression

Ghoge, Himani; Sharma, Sanjeevan; Sonawalla, Shamash; Parikh, Rajesh M.

doi:10.1007/s11920-003-0048-7

Cited by 19 publications

(12 citation statements)

References 43 publications

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“…Depressive symptoms are present in between 30 and 50% of patients with stroke [11,15,24,27]. In MMCA infarction, these percentages are even higher [5,33].…”

Section: Discussionmentioning

confidence: 99%

Quality of life and neurobehavioral changes in survivors of malignant middle cerebral artery infarction

et al. 2009

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Malignant middle cerebral artery (MMCA) infarction is associated with a mortality rate of 80% under conservative treatment. Decompressive hemicraniectomy (DH) reduces mortality and improves the functional outcome of surviving patients. The purpose of this study was to examine quality of life (QoL) and neurobehavioral deficits in patients with space-occupying infarctions of the right- or left-sided hemisphere at 6 months after stroke. The Sickness Impact Profile (SIP) was used to assess QoL in 19 out of 29 consecutive patients that underwent DH after a malignant MCA infarction (14 on the right and 5 on the left hemisphere). Behavioral changes were evaluated with the Frontal Behavioral Inventory and the Beck Depression Inventory. Patients and relatives were also asked if, knowing the present outcome, they would agree again, in retrospect, to a DH. Barthel Index >60 was seen in 37% of our patients. Functional outcome was related to age. We found a higher reduction in the SIP's physical domain than in the psychosocial domain. Depressive symptoms were present in 50% of the patients. We didn't find significant differences in QoL or functional outcome between patients with right or left-sided infarctions. The most frequent neurobehavioral symptoms were decreased speech output, apathy, reduced spontaneity and irritability. Most patients and their relatives would again give consent to hemicraniectomy. The results show that younger patients had a significantly better outcome. QoL seems to be acceptable in both left- and right-sided infarctions, and retrospective agreement to hemicraniectomy is high in both patients and their relatives.

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“…Depressive symptoms are present in between 30 and 50% of patients with stroke [11,15,24,27]. In MMCA infarction, these percentages are even higher [5,33].…”

Section: Discussionmentioning

confidence: 99%

Quality of life and neurobehavioral changes in survivors of malignant middle cerebral artery infarction

et al. 2009

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“…Moreover, measurements of therapeutic specificity and intensity at the acute care and rehabilitation hospitals should definitively be included in future prospective study given their possible influence on rehabilitation LOS and efficiency [40,41]. The documentation of depression, when present, that may lead to loss of motivation or hopelessness about recovery could also be beneficial since it may pose barriers to accomplishing optimal rehabilitation outcomes [42]. Finally, knowledge of the satisfaction level of all patients would bring additional insights to future study [43].…”

Section: Discussionmentioning

confidence: 99%

Ideal timing to transfer from an acute care hospital to an interdisciplinary inpatient rehabilitation program following a stroke: an exploratory study

Gagnon

Nadeau

Tam

2006

BMC Health Serv Res

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Background: Timely accessibility to organized inpatient stroke rehabilitation services may become compromised since the demand for rehabilitation services following stroke is rapidly growing with no promise of additional resources. This often leads to prolonged lengths of stays in acute care facilities for individuals surviving a stroke. It is believed that this delay spent in acute care facilities may inhibit the crucial motor recovery process taking place shortly after a stroke. It is important to document the ideal timing to initiate intensive inpatient stroke rehabilitation after the neurological event. Therefore, the objective of this study was to examine the specific influence of short, moderate and long onset-admission intervals (OAI) on rehabilitation outcomes across homogeneous subgroups of patients who were admitted to a standardized interdisciplinary inpatient stroke rehabilitation program.

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“…Most episodes of poststroke depression occur in the first 2 years after a cerebrovascular incident. The location of a lesion, particularly its proximity to the left frontal pole, has a profound impact on the frequency and severity of poststroke depression [180]. Poststroke mania is uncommon but can be clinically significant when lesions are within the right hemisphere [181].…”

Section: Evidence Base For Ect Effectiveness Efficacy and Tolerabilitymentioning

confidence: 99%

Current electroconvulsive therapy practice and research in the geriatric population

2014

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SUMMARY Electroconvulsive therapy (ECT) is utilized worldwide for various severe and treatment-resistant psychiatric disorders. Research studies have shown that ECT is the most effective and rapid treatment available for elderly patients with depression, bipolar disorder and psychosis. For patients who suffer from intractable catatonia and neuroleptic malignant syndrome, ECT can be life saving. For elderly patients who cannot tolerate or respond poorly to medications and who are at a high risk for drug-induced toxicity or toxic drug interactions, ECT is the safest treatment option. Organic causes are frequently associated with late-life onset of neuropsychiatric conditions, such as parkinsonism, dementia and stroke. ECT has proven to be efficacious even when these conditions are present. During the next decade, research studies should focus on the use of ECT as a synergistic therapy, to enhance other biological and psychological treatments, and prevent symptom relapse and recurrence.

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Cerebrovascular diseases and depression

Cited by 19 publications

References 43 publications

Quality of life and neurobehavioral changes in survivors of malignant middle cerebral artery infarction

Quality of life and neurobehavioral changes in survivors of malignant middle cerebral artery infarction

Ideal timing to transfer from an acute care hospital to an interdisciplinary inpatient rehabilitation program following a stroke: an exploratory study

Current electroconvulsive therapy practice and research in the geriatric population

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