Dafer Rima M, Rao Murali, Shareef Aisha, Sharma Aparna
Department of Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, USA.
Top Stroke Rehabil. 2008 Jan-Feb;15(1):13-21. doi: 10.1310/tsr1501-13.
Neuropsychological symptoms are probably among the most commonly ignored complications in stroke patients. Depression is a common yet often unrecognized neuropsychological consequence of stroke, having biological, psycho-behavioral, and social dimensions. The reported prevalence of depression following a stroke varies from 20% to 50% within the first year, with an apparent peak within the first 6 months of onset event. The disparity of reported prevalence rates significantly depends on study methodology, diagnostic assessment tools, and time elapsed after stroke onset. The etiology of depression after a stroke is complex; it is likely determined by multiple factors, including lesion location, social handicap, and family support. Depression impedes rehabilitation progress following stroke and is associated with impaired functional outcome, cognitive decline, and increased mortality. Similarly, depression has been linked to increased risk of stroke occurrence. Despite high prevalence and serious sequels, poststroke depression (PSD) remains undetected and untreated. Early diagnosis and successful intervention may improve clinical outcome and should be considered a key for better stroke care. In this article, we review the clinical presentation, epidemiology, pathogenesis, and consequences of PSD and summarize current recommendations for therapeutic intervention.
神经心理学症状可能是中风患者中最常被忽视的并发症之一。抑郁症是中风常见但往往未被认识到的神经心理学后果，具有生物学、心理行为和社会层面。据报道，中风后抑郁症在第一年的患病率从20%到50%不等，在发病后的前6个月内有一个明显的高峰。报道的患病率差异很大程度上取决于研究方法、诊断评估工具以及中风发作后的时间。中风后抑郁症的病因很复杂；它可能由多种因素决定，包括病变位置、社会障碍和家庭支持。抑郁症会阻碍中风后的康复进程，并与功能预后受损、认知衰退和死亡率增加有关。同样，抑郁症与中风发生风险增加有关。尽管患病率高且后遗症严重，但中风后抑郁症（PSD）仍未被发现和治疗。早期诊断和成功干预可能会改善临床结局，应被视为更好地护理中风患者的关键。在本文中，我们回顾了PSD的临床表现、流行病学、发病机制和后果，并总结了当前治疗干预的建议。
