Review article
Poststroke depression: An examination of the literature☆,☆☆

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Abstract

Objective: To examine literature on poststroke depression (PSD).

Data Sources: More than 200 articles related to stroke and depression were selected from a computer-based search spanning 1985 to 1995.

Study Selection: All relevant articles on PSD. Articles in foreign languages, case studies, anecdotal reports, book chapters, and reviews were excluded.

Data Extraction: Summary findings were independently reviewed by the authors.

Data Synthesis: PSD remains a frequent sequela of stroke; its prevalence remains uncertain because of continued methodologic problems in defining subject groupings and in utilizing psychiatrically normed assessment tools with neurologically impaired individuals, and because of the poor specificity/sensitivity of neuroendocrine markers in determining a diagnosis. The etiology of PSD appears to be complex and not fully understood. Although there has been much research on PSD, this review highlights the sparsity of available literature on its treatment.

Conclusion: The review points out the further need for more carefully designed studies of PSD that examine both assessment and treatment.

References (89)

  • C Zalewshik et al.

    Depressive symptomatology and post-stroke rehabilitation outcome

    Clin Geront

    (1994)
  • RM Parikh et al.

    The impact of poststroke depression on recovery in activities of daily living over a two-year follow-up

    Arch Neurol

    (1990)
  • PL Morris et al.

    Clinical depression is associated with impaired recovery from stroke

    Med J Aust

    (1992)
  • K Koivisto et al.

    Poststroke depression and rehabilitation outcome

    Nord J Psychiatry

    (1993)
  • M Sharpe et al.

    Depressive disorders in long-term survivors of stroke

  • PL Morris et al.

    Association of depression with 10-year poststroke mortality

    Am J Psychiatry

    (1993)
  • WA Gordon et al.

    Stroke: coping with a cognitive deficit

  • M Astrom et al.

    Psychosocial function and life satisfaction after stroke

    Stroke

    (1992)
  • M Ruckdeschel-Hibbard et al.

    Affective disturbances associated with brain damage

  • WG Gasparrini et al.

    Hemispheric asymmetries of affective processing as determined by Minnesota Multiphasic Personality Inventory

    J Neurol Neurosurg Psychiatry

    (1978)
  • RG Robinson et al.

    Post-stroke depressive disorders: a follow-up study of 103 patients

    Stroke

    (1982)
  • S Finklestein et al.

    Mood, vegetative disturbance and dexamethasone suppression test after stroke

    Ann Neurol

    (1982)
  • M Ruckdeschel-Hibbard

    Affective impairments in right brain damaged individuals

  • A Finset et al.

    Depressed mood and intra-hemispheric locations of lesion in right hemispheric stroke patients

    Scand J Rehabil Med

    (1989)
  • S Egelko et al.

    First year after stroke: tracking cognitive and affective deficits

    Arch Phys Med Rehabil

    (1989)
  • WA Gordon et al.

    Issues in the diagnosis of post-stroke depression

    Rehabil Psych

    (1991)
  • G Andersen et al.

    Incidence of post-stroke depression during the first year in a large unselected stroke population determined using a valid standardized rating scale

    Acta Psychiatr Scand

    (1994)
  • PLP Morris et al.

    Are there two depressive syndromes after stroke?

    J Nerv Ment Dis

    (1994)
  • AG Burvill et al.

    Prevalence of depression after stroke: the Perth community stroke study

    Br J Psychiatry

    (1995)
  • G Gianotti

    Emotional behavior and hemispheric side of lesion

    Cortex

    (1972)
  • SM McGlynn et al.

    Unawareness of deficits in neuropsychological syndromes

    J Clin Exp Neuropsychol

    (1989)
  • MR Hibbard et al.

    Unawareness in stroke patients: A problem of the mind not the body

    Arch Phys Med Rehabil

    (1990)
  • MR Hibbard et al.

    Awareness of disability in patients following stroke

    Rehabil Psych

    (1992)
  • ED Ross et al.

    Diagnosis and neuroanatomical correlates of depression in brain-damaged patients

    Arch Gen Psychiatry

    (1991)
  • MR Hibbard et al.

    A multi modal approach to the diagnosis of post-stroke depression

  • JP Fedoroff et al.

    Are depressive symptoms nonspecific in patients with acute stroke?

    Am J Psychiatry

    (1991)
  • PN Stein et al.

    The disciminative properties of somatic and non-somatic symptoms for post-stroke depression

    Clin Neuropsychol

    (1996)
  • KM Heilman et al.

    Hypoarousal in patients with neglect syndrome and emotional indifference

    Neurology

    (1978)
  • WA Gordon et al.

    The multifaceted nature of the cognitive deficits following stroke: an unexpected finding

    Arch Phys Med Rehabil

    (1985)
  • WA Gordon

    Methodlogical considerations in cognitive remediation

  • ED Ross

    The aprosodias

    Arch Neurol

    (1981)
  • SE Starkstein et al.

    Neuropsychological and neuroradiologic correlates of emotional prosody comprehension

    Neurology

    (1994)
  • BJ Carroll et al.

    A specific laboratory test for the diagnosis of melancholia: standardization, validation and clinical utility

    Arch Gen Psychiatry

    (1981)
  • M Bauer et al.

    Dexamethasone suppression test and depression in a rehabilitation setting

    Arch Phys Med Rehabil

    (1983)

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    ☆

    Supported in part by grant H133B30038, National Institute on Disability and Rehabilitation Research, United States Department of Education.

    ☆☆

    No commercial party having a direct or indirect interest in the subject matter of this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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    Copyright © 1997 Published by Elsevier Inc.