Post-Stroke Depression

Abstract

Objective : To review evidence of post-stroke depression (PSD) for symptoms,
diagnosis, differential diagnosis, epidemiology, course, risk factors, pathophysiology,
screening tools, treatment and prevention including both pharmacological and
non-pharmacological interventions.
Method : MEDLINE/Pubmed, EMBASE, Cochrane Central Register of Controlled Trials
and other medical databases were searched for articles published between 1923-2018,
written in English, Thai and other languages, using factors related to post-stroke
depression, depression, depressive disorder, stroke and cerebrovascular disease as
keywords.
Result : Depression is the most common neuropsychiatric consequence of stroke.
It affects treatment and rehabilitation for stroke, impairs functional outcome and
increases mortality rate. Diagnosis of PSD was frequently overlooked because of
complex clinical manifestation. Currently, there is variance between epidemiological
factors in each study as a result of various assessment tools and the setting in which
patients were examined. Pathophysiology and risk factors of PSD are determined by both
biological and psychosocial factors, for instance, genetics and social factor. Evidence
has supported the benefits of the pharmacotherapy and psychosocial intervention for
PSD treatment and prevention.
Conclusion : Currently, there has been an increasing evidence of PSD. Early
diagnosis should be done by clinical assessment and appropriate screening tools.
Both pharmacotherapy and non-pharmacological interventions have efficacy for PSD
treatment and prevention. However, further research is needed to improve the quality
of evidence.