Post-stroke depression, another handicap

Doi : PM-12-2006-35-12-C1-0755-4982-101019-200609335

Jean-Michel Pinoit^[1],

Yannick Bejot^[2],

Olivier Rouaud^[2],

Isabelle Benatru^[2],

Guy-Victor Osseby^[2],

Bernard Bonin^[1],

André Gisselmann^[1],

Maurice Giroud^[2]

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Abstract

Summary

Introduction > Post-stroke depression is a severe complication affecting 30-50% of patients during the first year. Experienced medical and paramedical staff in stroke units, using validated scales, can now identify initial signs of depression in the first days after stroke onset.

Methods > This review of the literature is based on a Medline search for the terms stroke, depression, and epidemiology. It discusses problems of pathophysiology, diagnosis, prognosis, and therapeutics.

Results > Depression is an emergency in stroke patients because it impedes rehabilitation and family and social insertion. Early diagnosis is difficult, but possible with clinical somatic and cognitive symptoms. Post-stroke depression may also be a marker of pending cognitive decline. Management requires both antidepressants and psychotherapy.

Conclusion > There is a pressing need for further research to improve clinical practice in this area of stroke care.