The prevalence of anxiety disorders and depression is assessed as between 20 and 50% following stroke. Depressive persons tend to give their overall life situation a worse rating than their relatives or physicians because of negative cognitions. Nevertheless, research concerning Quality of Life (QoL) after stroke hardly ever takes into account the methodological bias of assessing QoL only by self-rating. The aim of this study was to point out the important relationship between depression, anxiety and the autoassessment of QoL. QoL was markedly affected in the poststroke patients and in the chronic low back pain and myocardial ischemia patients, and it was rated worst by the most seriously depressed subjects. Clinical studies focusing on the ever more significant evaluation criterion ‘health-related QoL’ after stroke should take into account the high prevalence of anxiety and depressive symptoms and their major influence on the patients’ self-evaluated QoL.
In spite of the high incidence and prevalence of psychiatric complications after cerebrovascular injury few results have remained uncontradicted so far. This article focuses on the variety of psychiatric disorders after stroke reviewing recent literature and concentrating in particular on Post-stroke Depression. The prevalence of depressive disorders following stroke is assessed between 20 and 50%. Serious consequences for post-stroke depressed subjects are their increased mortality, poor rehabilitation outcome and long-term affected quality of life. Nevertheless, depressive disorders following stroke usually remain untreated. To this date the effectiveness of only a few drugs has been studied in controlled clinical trials (Nortriptylin, Citalopram, Imipramin, Mianserin). Besides describing clinical presentation, epidemiology, pathogenesis and consequences of post-stroke depressive disorders for the patient different authors' statements are listed and critically commented. Finally recommendations concerning therapeutic intervention are mentioned.
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