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Poststroke depression: prevalence, pathogenesis, diagnosis, and treatment

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The paper reviews the data available in the literature on the prevalence, pathogenesis, diagnosis, treatment, and prevention of poststroke depression. Depression develops in nearly one in every three patients, who have experienced stroke, and can negatively affect the rehabilitation process. The role of psychological factors, genetic predisposition, brain lesion location, monoamine deficiency in the pathogenesis of depression is considered. Poststroke depression is frequently diagnosed although it is detected using simple studies (Beck depression inventory, Hamilton rating scale). Psychotherapy is effective in preventing poststroke depression; the efficacy of antidepressants is actively being investigated. When depression develops, there is a positive result of treatment with antidepressants; a combination of psychotherapy and antidepressants produces even a more pronounced effect. The long-term (6-month or more) use of tricyclic antidepressants and selective serotonin reuptake inhibitors is noted to have a positive effect; there are data on the high efficacy and good tolerability of escitalopram in poststroke depression. It is stressed that the prevention and treatment of depression may substantially improve the rehabilitation process and quality of life.

About the Author

Vladimir Anatolyevich Parfenov

Department of Nervous System Diseases


1. <div><p>Дамулин И.В., Парфенов В.А., Скоромец А.А. и др. Нарушения кровообращения в головном и спинном мозге. В кн.: Болезни нервной системы. Рук-во для вра чей. Т.1. Под ред. Н.Н.Яхно. М.: Медицина, 2005, 232-303.</p><p>Скворцова В.И., Губский Л.В., Стаховская Л.В. и др. Ишемический инсульт. В кн.: Неврология, национальное руководство. Под ред. Е.И. Гусева, А.И. Коновалова, В.И. Скворцовой. М.: ГЭОТАР-Медиа, 2009;592-615.</p><p>Парфенов В.А., Хасанова Д.Р. Ишемический инсульт. М.: МИА, 2012;312 с.</p><p>European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. Cerebrovasc Dis 2008;25:457-507.</p><p>Вейн А.М., Вознесенская Т.Г., Голубев В.Л. и др. Депрессия в неврологической практике. 3-е изд. М.: МИА, 2007;197 с.</p><p>Скворцова В.И., Концевой В.А., Петрова Е.А. и др. Депрессии и парадепрессивные расстройства при церебральном инсульте: вопросы клинической оценки, диагностики и коррекции. Журн неврол и психиатр 2009;9:4-11.</p><p>Вознесенская Т.Г. Депрессия при цереброваскулярных заболеваниях. Неврол нейропсихиатр и психосом 2009;2:9-13.</p><p>Старчина Ю.А. Постинсультная депрессия; применение эсциталопрама. Неврол нейропсихиатр и психосом 2012;4:9-13.</p><p>Kanner A.M. Depression in neurological disorders. Lundbec Inst 2005;161 p.</p><p>Gaete J.M., Bogousslavsky J. Post-stroke depression. Exp Rev Neurother 2008;8:75-92.</p><p>Williams L.S., Shoma Ghose S., Swindle R.W. Depression and other mental health diagnoses increase mortality risk after ischemic stroke. Am J Psychiatry 2004;161:1090-5.</p><p>Capaldi V., Wynn I. Emerging strategies in the treatment of post-stroke depression and psychiatric distress in patients. Psychol Res Behav Manag 2010;3:109-18.</p><p>Hackett M.L., Yapa C., Parag V. et al. Frequency depression after stroke: a systematical review of observational studies. Stroke 2005;36:1330-40.</p><p>Hackett M.L., Anderson C.S., House A.O. et al. Interventions for Preventing Depression After Stroke. Stroke 2009;40:e485-6.</p><p>Willey J.Z., Disla N., Moon Y.P. et al. Early depressed mood after stroke predicts long-term disability. The Northern Manhattan stroke study (NOMASS). Stroke 2010;41:1896-900.</p><p>Whyte E.M., Mulsant B.H., Vanderbilt J. et al. Depression after stroke: a prospective epidemiological study. J Am Geriatr Soc 2004;52:774-8.</p><p>Ramasubbu R., Tobias R., Buchan A.M. et al. Serotonin transporter gen promoter region polymorphism associated with post-stroke major depression. J Neuropsychiatry Clin Neurosci 2006;18:96-9.</p><p>Berg A., Psych L., Lonnqvist J. et al. Assessment of Depression After Stroke. A Comparison of Different Screening Instruments. Stroke 2009;40:523-9.</p><p>Hackett M.L., Anderson C.S., House A.O. et al. Interventions for Treating Depression After Stroke. Stroke 2009;40:e487-8.</p><p>Hacket M.L., Anderson C.S. Treatments options for post-stroke depression in the elderly. Aging Health 2005;1:90-5.</p><p>Robinson R.G., Jorge R.E., Moser D.J. Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial. JAMA 2008;299:2391-400.</p><p>Jorge R.E., Robinson R.G., Arndt S. et al. Mortality and post-stroke depression: A placebo- controlled trial of antidepressants. Am J Psychiatry 2003;60:1823-9.</p><p>Cipriani A., Furukawa T.A., Salanti G. et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009;373:746-58.</p><p>Jorge R.E., Acion L., Moser D. et al. Escitalopram and enhancement of cognitive recovery following stroke. Arch Gen Psychiatry 2010;67:187-96.</p><p>Duman R.S., Monteggia L.M. A neurotrophic model for stress-related mood disorders. Biol Psychiatry 2006;59:1116-27.</p><p>Mikami K., Jorge R.E., Moser D.G. et al. Increased frequency of ferst-episode Poststroke depression after discontinuation of escitalopram. Stroke 2011;42:3281-3.</p><p>Ramasubbu R. Therapy for prevention of post-stroke depression. Exp Оpin Pharmacoter 2011;12:2177-87.</p><p>Mitchell P.H., Veith R.C., Becker K.J. Brief PsychosocialРBehavioral Intervention With Antidepressant Reduces Post-stroke Depression Significantly More Than Usual Care With Antidepressant. Stroke 2009;40:3073-8.</p></div><br />

For citation:

Parfenov V.A. Poststroke depression: prevalence, pathogenesis, diagnosis, and treatment. Neurology, Neuropsychiatry, Psychosomatics. 2012;4(4):84-88. (In Russ.)

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