
In recent years, post-stroke depression (PSD) has attracted a worldwide interest. This review addresses the major research issues of PSD. PSD is the most frequent psychic complication among stroke survivors. Depression has a significant impact on post-stroke recovery and mortality. The diagnosis of PSD is based on the structured mental state examination and DSM-IV criteria as well as on the scores of the clinical symptoms scale (the Hamilton Depression Rating Scale) and self-rated inventories. PSD is multifactorial in origin and develops under the influence of biopsychosocial factors. The anatomical correlates of PSD change over time. In acute stage and 3-6 months after stroke, depression is associated with left-hemisphere lesion severity and proximity of the lesion to the frontal pole and related to the dysfunction of (cortico-) striato-pallido-thalamic-cortical projections. In post-stroke period (1-2 years) depression is significantly associated with right-hemisphere lesion severity and proximity of the lesion to the occipital pole. The most relevant psychosocial risk factors for PSD are described as follows: past history of depression and other mental disorders, dysphasia, functional impairment, living alone and post-stroke social isolation. Selective serotonin reuptake inhibitors (citalopram and fluoxetine) may be effective in the treatment of PSD.
Stroke, Depression, Risk Factors, Incidence, Quality of Life, Humans, Prognosis
Stroke, Depression, Risk Factors, Incidence, Quality of Life, Humans, Prognosis
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