Recognizing poststroke depression
Melissa A. Schneider DNP, RN-BC, ONC
Matthew D.E. Schneider MSW, LCSW

December 2012 
Volume 42  Number 12
Pages 60 - 63
  PDF Version Available!

DEPRESSION AFTER STROKE is common but underrecognized, and it can impair a patient's rehabilitation. Poststroke depression (PSD) occurs in 30% to 60% of stroke patients, with the highest incidence 3 months poststroke.1-3 If the symptoms of PSD are recognized and treated with medication, psychotherapy, or both, almost 80% of patients improve.4This article will review the risk factors and signs and symptoms of PSD to promote early intervention and encourage patients to get treatment. Because PSD can develop after the patient recovers from the acute phase of a stroke, it's important to educate patients and families at discharge to ensure continuity of care.Each year in the United States, approximately 795,000 people are diagnosed with a stroke. Over 143,000 of these people die, making stroke the third leading cause of death and the number one cause of serious disability in adults.4Stroke can happen at any age, but risk exponentially increases with age. Three-quarters of all strokes occur in people over age 65, with the greatest increase in stroke incidence occurring in those over age 85.4Stroke usually has a rapid onset and is considered a medical emergency.5 During a stroke, blood flow is interrupted either by an obstruction (ischemic stroke) or vessel rupture (hemorrhagic stroke). Of these two causes, ischemic stroke is more common. Signs and symptoms of stroke, which vary depending on the area of the brain affected, may include sudden weakness or numbness of the face, arm, or leg, especially on one side of the body; sudden confusion or aphasia; dysphagia; visual disturbances in one or both eyes; sudden dizziness; severe headache; and difficulty with ambulation or loss of coordination or balance.4Because signs and symptoms of stroke are potentially debilitating and life-threatening, mental health issues are frequently overlooked.5 Depression, the most common mood disorder after a stroke, can impede a patient's recovery. Depressed patients are significantly more impaired

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