Diagnosis, phenomenology and treatment of poststroke depression

Abstract

Diagnosing depression in stroke patients is a challenge in neuropsychiatry since depression symptoms may overlap neurological deficit signs. The best approach is to assess the presence of depressive symptoms using semi-structured psychiatric interviews, such as the Present State Exam, the Structured Clinical Interview for DSM-IV or the Schedules for Clinical Assessment in Neuropsychiatry. The diagnosis of a depressive syndrome should be made according to standardized diagnostic criteria for mood disorders due to neurological disease such as in the DSM-IV or ICD-10. Depression rating scales such as the Hamilton Depression Scale and the Center for Epidemiologic Scales for Depression may be used to rate the depression severity and monitor the progression of antidepressant treatment. Most studies have reported the effectiveness of pharmacological treatment in patients with post-stroke depression, and there is preliminary evidence that the degree of impairment in activities od daily living (ADL) may improve as well.