Role of mHealth in overcoming the occurrence of post-stroke depression

Abstract

Depression associated with stroke affects roughly one-third of stroke survivors. Post-stroke depression (PSD) is thought to adversely influence functional outcome by limiting participation in rehabilitation, decreasing physical, social, and cognitive function, and affecting neuroplasticity thereby placing stroke survivors at high risk for future vascular events. PSD has also been associated with higher mortality rates after stroke. In Peru, a country where there is no national stroke program and mental health disorders are largely underdiagnosed and untreated, people with PSD are likely to be further challenged by dependency and impoverished conditions that will limit their use of ambulatory services, leading to inadequate clinical follow-up. In this scenario, mobile health (mHealth) technology offers a promising approach to extend access to high-quality and culturally tailored evidence-based psychological care to address PSD given that cell phone use, Internet connectivity, and digital health technology have met a rapid growth in the last years and thus contribute to the attainment of broader Sustainable Development Goals (SDGs). The limited evidence of the effectiveness of mHealth for PSD calls for researchers to fill a knowledge gap where Peru poses as an ideal setting because rapid expansion of digital technology and current mental healthcare reform could be leveraged to enhance post-stroke outcomes. This article proposes the rationale for a suitable evidence-driven, mHealth-based, PSD self-management intervention called iMOODS-Investigating the role of mHealth in overcoming occurrence of depression after stroke-that could be tested among recent stroke patients with PSD in resource constrained settings.

Telehealth Interventions to Support Self-Management in Stroke Survivors: A Systematic Review

“…PSD occurs in one-third of stroke survivors [ 30 ] and has a negative effect on the restriction of participation in the rehabilitation process, decline in physical, cognitive, and social functions, and the biological process of neuroplasticity [ 31 ]. However, according to previous studies, many patients with PSD are not treated, and accordingly, innovative strategies to identify and treat PSD are needed [ 32 ]. One study in this review used TH-SM support as one of the approaches to PSD and demonstrated positive results [ 27 ].…”

Factors related to post-stroke depression during the first 2 weeks after stroke

“…Furthermore, low levels of physical activity and motivation are known to hinder improvement in motor paralysis, sensory disturbance, higher brain dysfunction, and impairment in activities of daily living (ADL) (Kutlubaev and Hackett, 2014; Shimoda and Robinson, 2016). Mortality rates can be up to 10 times higher in patients with PSD than in those without (Miranda et al., 2018). According to a systematic review of previous studies, the reported prevalence of depression was 29%, with a cumulative incidence of 39–52% within 5 years of stroke (Ayerbe et al., 2013).…”

Mechanisms of Transcranial Magnetic Stimulation Treating on Post-stroke Depression

“…Post-stroke depression (PSD) is a severe and fearful complication that occurs in nearly one third of patients who suffer stroke and can even occur in patients who have suffered only a minor stroke or transient ischemic attack (TIA; Carnes-Vendrell et al, 2016 ). PSD can affect functional ability, rehabilitation outcome, and quality of life, and is related to a higher mortality rate of stroke patients (Miranda et al, 2018 ). Additionally, stroke severity is an important risk factor for PSD, as is the mental history of the patient.…”