Abstract
Poststroke depression (PSD) is a relatively frequent psychiatric comorbidity with prevalence rates ranging between 30% and 50%. Typically, PSD tends to occur between the third and sixth month following a stroke and may be identical to primary major or minor depressive episodes. However, some elderly patients (aged 65 years and older) with bilateral silent or overt subcortical strokes may present a different type of depression in which depressed mood is associated with cognitive disturbances with impairment of executive functions, psychomotor retardation, poor insight, and impaired activities of daily living. This type of PSD is known as vascular depression. Stroke and depressive disorders have a bidirectional relation, whereby not only are patients with stroke at greater risk of developing a PSD, but patients with a history of depression are at greater risk of developing a stroke. This relation is mediated by the existence of common pathogenic mechanisms operant in both conditions, which include anti-inflammatory processes, a hyperactive hypothalamic-pituitary-adrenal axis that can result in a hypercoagulable state, as well as cardiac disturbances. The presence of PSD is associated with a worse recovery of activities of daily living, cognitive disturbances, and a higher mortality risk. Thus, early identification of PSD is of the essence so that treatment can be started without delay.
| Original language | English (US) |
|---|---|
| Title of host publication | Depression in Neurologic Disorders: Diagnosis and Management |
| Publisher | Wiley-Blackwell |
| Pages | 116-125 |
| Number of pages | 10 |
| ISBN (Print) | 9781444330588 |
| DOIs | |
| State | Published - Jul 4 2012 |
| Externally published | Yes |
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Keywords
- Cerebrovascular accident
- Cytokinins
- Dysthymia
- Major depressive disorder
- Serotonin
- Vascular depression
ASJC Scopus subject areas
- Neuroscience(all)
Cite this
Poststroke Depression. / Kanner, Andres M.
Depression in Neurologic Disorders: Diagnosis and Management. Wiley-Blackwell, 2012. p. 116-125.Research output: Chapter in Book/Report/Conference proceeding › Chapter
}
TY - CHAP
T1 - Poststroke Depression
AU - Kanner, Andres M
PY - 2012/7/4
Y1 - 2012/7/4
N2 - Poststroke depression (PSD) is a relatively frequent psychiatric comorbidity with prevalence rates ranging between 30% and 50%. Typically, PSD tends to occur between the third and sixth month following a stroke and may be identical to primary major or minor depressive episodes. However, some elderly patients (aged 65 years and older) with bilateral silent or overt subcortical strokes may present a different type of depression in which depressed mood is associated with cognitive disturbances with impairment of executive functions, psychomotor retardation, poor insight, and impaired activities of daily living. This type of PSD is known as vascular depression. Stroke and depressive disorders have a bidirectional relation, whereby not only are patients with stroke at greater risk of developing a PSD, but patients with a history of depression are at greater risk of developing a stroke. This relation is mediated by the existence of common pathogenic mechanisms operant in both conditions, which include anti-inflammatory processes, a hyperactive hypothalamic-pituitary-adrenal axis that can result in a hypercoagulable state, as well as cardiac disturbances. The presence of PSD is associated with a worse recovery of activities of daily living, cognitive disturbances, and a higher mortality risk. Thus, early identification of PSD is of the essence so that treatment can be started without delay.
AB - Poststroke depression (PSD) is a relatively frequent psychiatric comorbidity with prevalence rates ranging between 30% and 50%. Typically, PSD tends to occur between the third and sixth month following a stroke and may be identical to primary major or minor depressive episodes. However, some elderly patients (aged 65 years and older) with bilateral silent or overt subcortical strokes may present a different type of depression in which depressed mood is associated with cognitive disturbances with impairment of executive functions, psychomotor retardation, poor insight, and impaired activities of daily living. This type of PSD is known as vascular depression. Stroke and depressive disorders have a bidirectional relation, whereby not only are patients with stroke at greater risk of developing a PSD, but patients with a history of depression are at greater risk of developing a stroke. This relation is mediated by the existence of common pathogenic mechanisms operant in both conditions, which include anti-inflammatory processes, a hyperactive hypothalamic-pituitary-adrenal axis that can result in a hypercoagulable state, as well as cardiac disturbances. The presence of PSD is associated with a worse recovery of activities of daily living, cognitive disturbances, and a higher mortality risk. Thus, early identification of PSD is of the essence so that treatment can be started without delay.
KW - Cerebrovascular accident
KW - Cytokinins
KW - Dysthymia
KW - Major depressive disorder
KW - Serotonin
KW - Vascular depression
UR - http://www.scopus.com/inward/record.url?scp=84886355966&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84886355966&partnerID=8YFLogxK
U2 - 10.1002/9781118348093.ch10
DO - 10.1002/9781118348093.ch10
M3 - Chapter
AN - SCOPUS:84886355966
SN - 9781444330588
SP - 116
EP - 125
BT - Depression in Neurologic Disorders: Diagnosis and Management
PB - Wiley-Blackwell
ER -