Poststroke Depression: Importance of Its Detection and Treatment

Gabaldón, Laura; Fuentes, Blanca; Frank-García, Ana; Díez‐Tejedor, Exuperio

doi:10.1159/000107394

Cited by 49 publications

(30 citation statements)

References 120 publications

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“…The relation between LEC and depression in stroke patients is confirmed by the similar results obtained by Andersen [4] and by Gabaldon et al [12] treating with the selective serotonin reuptake inhibitors citalopram and sertraline stroke patient with PSD and hyperemotionalism. According to these results, increased emotionalism of stroke patients could be considered as a facet of PSD.…”

Section: Psychiatric Historysupporting

confidence: 76%

Post-Stroke Depression: Main Phenomenological Clusters and their Relationships with Clinical Measures

Quaranta

Marra

Gainotti

2012

Behavioural Neurology

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Abstract. Objectives:To investigate the principal psychopathological dimensions of post-stroke depression (PSD) through the assessment of the factorial structure of the Post-Stroke Depression Rating Scale (PSDRS). Methods: We enrolled ninety-eight subjects with PSD, who underwent the PSDRS, MMSE and Barthel Index. Information about demographic, clinical, and neuroanatomical factors was collected.Results: The factor analysis extracted three factors accounting for 63.4% of the total variance, and identified as: 1) "Depressive and Anxious Symptoms" (DAS); 2) "Lack of Emotional Control" (LEC); 3) "Reduced Motivation" (RM). On multivariate statistics, DAS severity was predicted by previous history of mood disorders and Barthel Index; LEC severity was predicted by Barthel Index; RM severity was predicted by age. Conclusions: The PSDRS displayed a reliable factor structure that agreed with previous interpretation of PSD. In particular, core depressive symptoms seem to be related to premorbid personality and functional status, whereas apathy/anhedonia may be connected to brain aging.

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Section: Psychiatric Historysupporting

confidence: 76%

Post-Stroke Depression: Main Phenomenological Clusters and their Relationships with Clinical Measures

Quaranta

Marra

Gainotti

2012

Behavioural Neurology

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“…The observed frequency in use of antidepressives is higher than reported in other recent stroke studies [18, 19]. As treatment of depressive symptoms (or poststroke prophylactic treatment) may help to avoid a deterioration of the cognitive function as well as prolongation of the rehabilitation period, both of which are associated with increased morbidity and mortality [20, 21], our results should be considered encouraging. However, it is also clear from our multivariate analysis, where we adjusted for the use of antidepressives, that the most important predictive factors for development of depressed mood at 90 days after ICH relate to the well-known short-term physical and neurological disabilities associated with this condition.…”

Section: Discussionsupporting

confidence: 45%

Depressed Mood after Intracerebral Hemorrhage: The FAST Trial

et al. 2009

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Background and Purpose: Depression is a frequent and important complication of stroke. Few data exist on the prevalence of depression/depressed mood after intracerebral hemorrhage (ICH) and the relationship between depression/depressed mood and the quality of life (QoL) more generally experienced by survivors of ICH. Methods: Factor Seven for Acute Hemorrhagic Stroke (FAST) was a randomized, multicenter, double-blind, placebo-controlled trial conducted between May 2005 and February 2007 at 122 sites in 22 countries. All patients were evaluated at day 90 after ICH onset for depressed mood and QoL with the Hamilton Depression Rating Scale (HDRS) and the EuroQoL, respectively. Multivariate stepwise logistic regression was used to develop a predictive model for depressed mood at day 90. Relationships between HDRS and EuroQoL scores at day 90 were evaluated with Spearman correlation coefficients. Results: 657 patients were alive at 3 months after ICH onset; 596 (91%) completed the HDRS. Twenty percent reported an HDRS score >10, indicating at least a minor degree of depressed mood; 6% endorsed symptoms of severely depressed mood. Significant predictors of depressed mood included comorbidities (p = 0.0022), moderate to severe neurological impairment according to the National Institutes of Health Stroke Scale (NIHSS) at day 15 (p = 0.0097), physical disability as measured by the Barthel Index (BI) at day 15 (p = 0.0486), and female gender (p = 0.04), but not hemorrhage severity or a history of depression. Irrespective of the presence of post-ICH disability and impairment, the severity of depressed mood at day 90 was significantly correlated with poor QoL. Conclusion: Depressed mood affects approximately 20% of ICH survivors and adversely affects QoL. Physicians should be vigilant to ensure that chronically ill and severely impaired survivors of ICH are adequately monitored and treated for depression after ICH.

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“…Depression also has a negative effect on social functioning and the quality of life of patients [23,24,25,26]. …”

Section: Introductionmentioning

confidence: 99%

Is Poststroke Depression a Major Depression?

Silva

Brasil²,

Nascimento³

et al. 2013

Cerebrovasc Dis

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Background: Poststroke depression (PSD) is the most common neuropsychiatric consequence of stroke. A large number of studies have focused on the pathogenesis of PSD, but only a few aimed to characterize its psychopathology; these studies yielded results that are difficult to compare because of the different methods utilized. The current study aimed to characterize the symptom profile of PSD in an attempt to better understand the disease and allow a more accurate diagnosis. Methods: The study sample comprised 64 patients divided into three groups: stroke patients without diagnosis of depression (n = 33), stroke patients diagnosed with PSD (PSD group, n = 14) and patients diagnosed with major depression (MD) but with no clinical comorbidity (MD group, n = 17). All patients were diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). The initial diagnostic interview was complemented by the Mini Mental State Examination (MMSE), the Rankin Scale, and four scales for the assessment of the intensity of symptoms of anxiety and depression: the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression General Scale (HADS), the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). The Star Plot, a graphical method of data visualization, was used to analyze the results. The t test was used for independent samples (two-tailed analysis). Results: As measured by the BDI, HAM-D and HAM-A scales and HADS depression subscale, the average total scores of symptoms for the sample of patients diagnosed with MD without clinical comorbidity was significantly higher than that of the PSD patients (p < 0.05). Similar results were obtained by plotting the BDI data on Star Plot. The PSD patients showed mild typical depressive symptoms such as less depressed mood, anhedonia, disinterest, guilt, negative thoughts, depreciation, suicidal ideation and anxiety, when evaluated by the HAM-A scale. Moreover, the somatic symptoms of depression did not lead to increased diagnosis of major depression in stroke patients. Conclusions: The results indicate that the PSD clinical picture comprised, in general, symptoms of mild/moderate intensity, especially those considered as pillars for the diagnosis of depression: depressed mood, loss of pleasure and lack of interest. Given the imprecision of boundaries that separate the clinical forms of depression from subclinical and nonpathological forms, or even from the concepts of demoralization and adjustment disorders, we situate PSD in a complex biopsychosocial context in which a better understanding of its psychopathological profile could provide diagnostic and therapeutic alternatives best suited to the difficult reality experienced by stroke patients.

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Poststroke Depression: Importance of Its Detection and Treatment

Cited by 49 publications

References 120 publications

Post-Stroke Depression: Main Phenomenological Clusters and their Relationships with Clinical Measures

Post-Stroke Depression: Main Phenomenological Clusters and their Relationships with Clinical Measures

Depressed Mood after Intracerebral Hemorrhage: The FAST Trial

Is Poststroke Depression a Major Depression?

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