Post stroke depression: The sequelae of cerebral stroke

• Published in: Neuroscience and biobehavioral reviews Vol. 90; pp. 104 - 114
• Main Authors: Das, Jyotirekha, G.K., Rajanikant
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01-07-2018
• Subjects: Cognition Disorders - complications; Cognition Disorders - psychology; Depression - complications; Depression - psychology; Depressive Disorder - complications; Depressive Disorder - psychology; Etiology; Humans; Ischemic stroke; Post stroke depression; Pre-stroke depression; Predictors; Risk Factors; Screening; Stroke - complications; Stroke Rehabilitation - psychology; Therapeutics; RCT; BBB; IVR; MRI; CBF; BDI; Ischemic stroke; PHQ-9; TNF; CBT; Pre-stroke depression; IDO; Etiology; NMDA; mECT; HDRS; IGF-1R; DSM; Predictors; PSD; NIHSS; MCAO; IL; BDNF; HTTLPR; VEGF; IGF-1; BAI; PGF; CVD; DEPRESS; SSRI; fMRI; HAMD; Screening; TCA; ECT; Therapeutics; HPA; CES-D; LMIC; NICE; Post stroke depression; PCP; rTMS; PET
• ISSN: 0149-7634; 1873-7528
• DOI: 10.1016/j.neubiorev.2018.04.005

•Post-stroke depression is a frequent neuropsychiatric manifestation of high clinical importance.•The pathophysiology of post-stroke depression is poorly understood.•Pre-stroke depression, physical disability, cognitive impairment and stroke severity are the most consistent predictors.•Screening and diagnosis of post-stroke depression need special attention.•While pharmacological interventions are a mainstay in the management of post-stroke depression, evidence-based psychotherapy is gaining popularity and approval from healthcare professionals.
Post-stroke depression (PSD) is the most common mental health issue, afflicting around 33% of stroke survivors. PSD has a negative impact on the rehabilitation, recuperation of motor and cognitive deficits following stroke and significantly increases the chances of relapsing neurovascular events. It has been demonstrated that biological and psychological factors have a significant role in PSD. Numerous endeavors have been made to discover the risk factors and predictors of PSD. Screening and diagnosis also have gained attention; however, a suitable tool is yet to be developed. Medications are chosen based on their viability and reaction profile in the patients. Besides pharmacotherapy, psychotherapy treatment is also highly valued by both psychiatrists and stroke patients. Additional research is needed to examine the pathophysiology of PSD. This review attempts to highlight the existing evidence and gaps in the present knowledge of the predictors of PSD, incidence, prevalence, and etiology. Further, it also discusses the screening and diagnostic approaches, therapeutic modalities and management of PSD and the impact of pre-stroke depression on PSD.