Epidemiology and treatment of post-stroke depression

Fondazione Santa Lucia - I.R.C.C.S Rome, Italy.
Neuropsychiatric Disease and Treatment (Impact Factor: 1.74). 03/2008; 4(1):145-54. DOI: 10.2147/NDT.S2017
Source: PubMed


Mood depression is a common and serious complication after stroke. According to epidemiological studies, nearly 30% of stroke patients develop depression, either in the early or in the late stages after stroke. Although depression may affect functional recovery and quality of life after stroke, such condition is often ignored. In fact, only a minority of patients is diagnosed and even fewer are treated in the common clinical practice. Moreover, the real benefits of antidepressant (AD) therapy in post-stroke depression have not been fully clarified. In fact, controlled studies on the effectiveness of ADs in post stroke depression (PSD) are relatively few. Today, data available suggest that ADs may be generally effective in improving mood, but guidelines for the optimal treatment and its length are still lacking.

Download full-text


Available from: Stefano Paolucci
  • Source
    • "Depression can occur at any stage after stroke (acute, subacute , and chronic), although some authors classify this condition as common mainly in the second phase of the disease [4]. Poststroke depression is associated with an increased disability and increased cognitive impairment and leads to delay of the rehabilitation process, due to the deterioration of motivation and low mood [5]. What is important in patients with PSD appears to be 3-4-fold increase in short-and longterm mortality compared with nondepressed patients [6]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Poststroke depression, the second most serious psychosomatic complication after brain stroke, leads to delay of the rehabilitation process and is associated with an increased disability and cognitive impairment along with increase in term mortality. Research into the biochemical changes in depression is still insufficiently described. The aim of our study was therefore to evaluate the possible association between plasma protein oxidative/nitrative damages and the development of poststroke depression. We evaluated oxidative/nitrative modifications of specific proteins by measurement of 3-nitrotyrosine and carbonyl groups levels using ELISA test. Additionally, we checked differences in proteins thiol groups by spectrophotometric assay based on reaction between DTNB and thiols. We also evaluated catalase activity in erythrocytes measured as ability to decompose H2O2. Correlation analysis was performed using Spearman’s rank. We observed significant ( P < 0.001 ) differences in all oxidative/nitrative stress parameters in brain stroke patients compared to healthy group. Our research shows that oxidative damage of proteins is correlated with the degree of poststroke depression, while nitrative changes do not show any relationship. We demonstrate a positive correlation between the concentration of carbonyl groups and the Geriatric Depression Scale and a negative correlation between the degree of depression and the concentration of -SH groups or catalase activity.
    Full-text · Article · Apr 2015 · Oxidative Medicine and Cellular Longevity
  • Source
    • "Previous studies of the frequency of post-stroke depression have reported small differences in the 20~60% range. In the present study, the frequency of post-stroke depression was 22.5%, lower than the 30% reported by other studies13, 14), because we used a cutoff score of 21 compared to 10 used in the other studies. "
    [Show abstract] [Hide abstract]
    ABSTRACT: [Purpose] This study investigated the primary factors behind changes in depressive symptoms among stroke patients after 8 weeks of rehabilitation (physical, occupational, and cognitive therapy). [Methods] This study was conducted using a literature review, and electronic medical records from January, 2008 to December, 2009. Data were collected for 120 subjects with chronic stroke. [Results] Cardiac disorder, left-brain lesion, early-stage depression, activities of daily living, and cognitive function were significant predictors of the changes in depression in chronic stroke patients. [Conclusion] Post-stroke depression can be controlled by rehabilitation. Also, clinicians should comprehend and share the psychological and physical affliction, develop back-up programs, and make them comprehensively available to support the psychological and physical health of subjects with chronic stroke.
    Full-text · Article · Aug 2014 · Journal of Physical Therapy Science
  • Source
    • "At present, despite the abundant available literature, it is still difficult to define the true prevalence rate of PSD. This variability between studies arises not only from the methodological problems of the investigations but also from the complexity in recognizing, assessing, and diagnosing depression [14]. A study in Norway summarized that the prevalence of depressive disorder and depressive symptoms in the acute phase ranged widely from 5% to 54% [15]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Post-stroke depression (PSD) is commonly observed among stroke survivors. However, statistical analysis of such data is scarce in developing countries. The purpose of this study is to examine the incidence of PSD and its relationship with stroke characteristics in China. This was a prospective hospital-based study. Stroke patients were assessed within two weeks after acute ischemic stroke onset and then reevaluated at three months. Hamilton Depression Scale (HAMD) was used for screening depression (PSD). Subjects with HAMD score of ≥7 were further assessed with the World Health Organization Composite International Diagnostic Interview. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS). Stroke outcome was measured by the modified Rankin Scale (mRS). One hundred and two stroke patients were recruited, only ninety-one patients completed del period (men = 53, 63.74%), with mean age 60.0±10.4 years (range, 34-82 years). The incidence of PSD was 27.47% two weeks after stroke. The occurrence of PSD was unrelated with age, stroke type, stroke lesion and the history of disease. In univariate analysis gender, PSD was correlated with female gender. In multivariate logistic regression analysis, poor stroke outcome (mRS≥3) (OR 12.113, CI 1.169 to 125.59, P<0.05) was the important predictors of PSD. The study indicated that gender, functional dependence and stroke outcome are determinants of PSD occurrence during the first 2 weeks after stroke in China.
    Full-text · Article · Nov 2013 · PLoS ONE
Show more