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Related Experiment Videos

Determinants and consequences of post-stroke depression.

Guido Gainotti1, Camillo Marra

  • 1Neuropsychology Service of the Policlinico Gemelli/Catholic University of Rome, Rome, Italy. iclnp@rm.unicatt.it

Current Opinion in Neurology
|January 18, 2002
PubMed
Summary

Post-stroke depression (PSD) remains controversial. While selective serotonin reuptake inhibitors show promise for treating PSD, evidence for psychological interventions and the neuroanatomical model is inconclusive.

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Area of Science:

  • Neurology
  • Psychiatry
  • Clinical Medicine

Background:

  • Post-stroke depression (PSD) is a common and significant complication following a stroke.
  • Despite extensive research, controversies persist regarding PSD's incidence, determinants, consequences, and treatment.
  • Existing literature presents conflicting views on neuroanatomical versus psychological interpretations of PSD.

Purpose of the Study:

  • To critically evaluate the incidence, determinants, consequences, and treatment of post-stroke depression.
  • To update the ongoing debate on neuroanatomical versus psychological models of PSD.
  • To synthesize current evidence on the efficacy of pharmacological and psychological interventions for PSD.

Main Methods:

  • A comprehensive survey and critical discussion of existing literature on post-stroke depression.

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  • Analysis of factors influencing PSD incidence estimates.
  • Review of evidence supporting neuroanatomical and psychological theories of PSD.
  • Evaluation of the impact of PSD on functional recovery and treatment outcomes.

    • Main Results:

    • Recent evidence challenges Robinson's neuroanatomical model, which posits left frontal strokes cause major PSD.
    • The influence of PSD on functional recovery remains unclear; improvement in PSD does not guarantee improved functional status.
    • Pharmacological treatment with selective serotonin reuptake inhibitors (SSRIs) is effective and safe for PSD.

    Conclusions:

    • The neuroanatomical model for PSD requires further reevaluation.
    • The relationship between PSD improvement and functional recovery requires more investigation.
    • SSRIs are a recommended pharmacological approach for PSD, while psychological treatments require more conclusive evidence.