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Post-stroke depression: psychological, neuropsychological, HHA axis, localization of stroke aspects and treatment

BACKGROUND: The prevalence of post-stroke depression (PSD) is elevated. Some risk factors and poor outcome have been associated with PSD. The treatment of PSD reduced the negative impact in patients recovery. Appart from these data the PSD has been under diagnosed and under treated. OBJECTIVE: Review some aspects such as quality of life, cognitive dysfunction, hypercortisolism, stroke localization and treatment of PSD. METHODS: MedLine/PubMed database search using the terms post-stroke depression, stroke, quality of life, hypercortisolism, cognitive dysfunction and treatment, published in MedLine in the last 10 years. RESULTS: PSD has a high rate of prevalence, from 23% to 60%. Few incidence rates are investigated. PSD is associated with poor outcome, increase of cognitive dysfunction and reduced quality of life. The hypercortisolism seems to be associated with PSD in the latter period of stroke. Stroke in the left frontal region, basal ganglia and some structures of prefrontosubcortical circuits have been related with frequency and severity of PSD. DISCUSSION: Some programs can be used to assist the medical care researcher with these patients in diagnosis and treatment of PSD. The research needs to be continued with clear methodological protocols in order to understand the physiopathology related to the incident PSD.

post-stroke depression; stroke; depression; quality of life; cognitive dysfunction; hypercortisolism; treatment


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