Schwartz J A, Speed N M, Brunberg J A, Brewer T L, Brown M, Greden J F
Department of Psychiatry, University of Michigan, Ann Arbor.
Biol Psychiatry. 1993 May 15;33(10):694-9. doi: 10.1016/0006-3223(93)90118-w.
Despite recent advances in understanding the pathophysiology of poststroke depression, major questions remain. They include the relative importance of lesion location and size and the confounding effects of time since stroke, age, prior history of depression, and cerebral atrophy. To evaluate these issues, we systematically assessed depressive features, functional status, and brain structure with computer tomography scans in 91 men undergoing stroke rehabilitation. Forty percent met DSM-III criteria for major depressive disorder. Mood disturbance was more severe for patients with right than with left hemisphere lesions, correlated with functional disability and lesion size, and was associated with previous history of depression. Age, time since stroke, and atrophy did not correlate with mood. Depression is common in delayed stroke recovery, regardless of lesion location. Because there are no demographic or anatomic features that predict the absence of depression, depression screening should be part of the assessment of all patients undergoing stroke rehabilitation.
尽管最近在理解中风后抑郁症的病理生理学方面取得了进展，但主要问题仍然存在。这些问题包括病变位置和大小的相对重要性，以及中风后的时间、年龄、既往抑郁症病史和脑萎缩的混杂影响。为了评估这些问题，我们对91名正在接受中风康复治疗的男性进行了计算机断层扫描，系统地评估了他们的抑郁特征、功能状态和脑结构。40%的人符合《精神疾病诊断与统计手册》第三版中重度抑郁症的标准。右半球病变患者的情绪障碍比左半球病变患者更严重，与功能残疾和病变大小相关，并且与既往抑郁症病史有关。年龄、中风后的时间和萎缩与情绪无关。无论病变位置如何，抑郁症在中风恢复延迟中都很常见。由于没有人口统计学或解剖学特征可以预测抑郁症的不存在，因此抑郁症筛查应该成为所有接受中风康复治疗患者评估的一部分。
