Skip to main content
SpringerLink
Log in

Depression After Stroke

  • Chapter
  • First Online:
Neuropsychiatric Symptoms of Cerebrovascular Diseases

Part of the book series: Neuropsychiatric Symptoms of Neurological Disease ((NSND))

Abstract

Poststroke depression (PSD) is among the most common neuropsychiatric sequelae of stroke. Cross-sectional studies have demonstrated that about one-third of patients develop depression during the acute stage after stroke and more than 50 % suffer depression at some later point. PSD is strongly associated with negative outcomes, such as increased length of hospital stay, increased severity of neurological and functional deficits, more severe cognitive deficits, worse quality of life, and increased mortality. Randomized controlled trials have demonstrated the efficacy of nortriptyline, citalopram, and reboxetine to treat PSD. Recent studies also suggest that prophylactic treatment with antidepressants may significantly decrease the incidence of PSD, although more research in this area is needed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Robinson RG. The clinical neuropsychiatry of stroke. 2nd ed. Cambridge: Cambridge University Press; 2006.

    Book  Google Scholar 

  2. Rifkin A, Reardon G, Siris S, Karagji B, Kim YS, Hackstaff L, et al. Trimipramine in physical illness with depression. J Clin Psychiatry. 1985;46(2 Pt 2):4–8.

    PubMed  CAS  Google Scholar 

  3. Bukberg J, Penman D, Holland JC. Depression in hospitalized cancer patients. Psychosom Med. 1984;46(3):199–212.

    PubMed  CAS  Google Scholar 

  4. Endicott J. Measurement of depression in patients with cancer. Cancer. 1984;53(10 Suppl):2243–9.

    PubMed  CAS  Google Scholar 

  5. Rapp SR, Vrana S. Substituting nonsomatic for somatic symptoms in the diagnosis of depression in elderly male medical patients. Am J Psychiatry. 1989;146(9):1197–200.

    PubMed  CAS  Google Scholar 

  6. Paradiso S, Ohkubo T, Robinson RG. Vegetative and psychological symptoms associated with depressed mood over the first two years after stroke. Int J Psychiatry Med. 1997;27(2):137–57.

    Article  PubMed  CAS  Google Scholar 

  7. Cumming TB, Churilov L, Skoog I, Blomstrand C, Linden T. Little evidence for different phenomenology in poststroke depression. Acta Psychiatr Scand. 2010;121(6):424–30.

    Article  PubMed  CAS  Google Scholar 

  8. Spalletta G, Robinson RG. How should depression be diagnosed in patients with stroke? Acta Psychiatr Scand. 2010;121(6):401–3.

    Article  PubMed  Google Scholar 

  9. Robinson RG, Spalletta G. Poststroke depression: a review. Can J Psychiatry. 2010;55(6):341–9.

    PubMed  Google Scholar 

  10. Astrom M, Adolfsson R, Asplund K. Major depression in stroke patients. A 3-year longitudinal study. Stroke. 1993;24(7):976–82.

    Article  PubMed  CAS  Google Scholar 

  11. Starkstein SE, Robinson RG, Price TR. Comparison of spontaneously recovered versus nonrecovered patients with poststroke depression. Stroke. 1988;19(12):1491–6.

    Article  PubMed  CAS  Google Scholar 

  12. Starkstein SE, Robinson RG, Price TR. Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. Brain. 1987;110(Pt 4):1045–59.

    Article  PubMed  Google Scholar 

  13. Bhogal SK, Teasell R, Foley N, Speechley M. Lesion location and poststroke depression: systematic review of the methodological limitations in the literature. Stroke. 2004;35(3):794–802.

    Article  PubMed  Google Scholar 

  14. Morris PL, Robinson RG, Raphael B, Hopwood MJ. Lesion location and poststroke depression. J Neuropsychiatry Clin Neurosci. 1996;8(4):399–403.

    PubMed  CAS  Google Scholar 

  15. Carson AJ, MacHale S, Allen K, Lawrie SM, Dennis M, House A, et al. Depression after stroke and lesion location: a systematic review. Lancet. 2000;356(9224):122–6.

    Article  PubMed  CAS  Google Scholar 

  16. Shimoda K, Robinson RG. The relationship between poststroke depression and lesion location in long-term follow-up. Biol Psychiatry. 1999;45(2):187–92.

    Article  PubMed  CAS  Google Scholar 

  17. Narushima K, Kosier JT, Robinson RG. A reappraisal of poststroke depression, intra- and inter-hemispheric lesion location using meta-analysis. J Neuropsychiatry Clin Neurosci. 2003;15(4):422–30.

    Article  PubMed  CAS  Google Scholar 

  18. Parikh RM, Robinson RG, Lipsey JR, Starkstein SE, Fedoroff JP, Price TR. The impact of poststroke depression on recovery in activities of daily living over a 2-year follow-up. Arch Neurol. 1990;47(7):785–9.

    Article  PubMed  CAS  Google Scholar 

  19. Pohjasvaara T, Vataja R, Leppavuori A, Kaste M, Erkinjuntti T. Depression is an independent predictor of poor long-term functional outcome post-stroke. Eur J Neurol. 2001;8(4):315–9.

    Article  PubMed  CAS  Google Scholar 

  20. Donnellan C, Hickey A, Hevey D, O’Neill D. Effect of mood symptoms on recovery one year after stroke. Int J Geriatr Psychiatry. 2010;25(12):1288–95.

    Article  PubMed  CAS  Google Scholar 

  21. Hackett ML, Anderson CS. Predictors of depression after stroke: a systematic review of observational studies. Stroke. 2005;36(10):2296–301.

    Article  PubMed  Google Scholar 

  22. Narushima K, Robinson RG. The effect of early versus late antidepressant treatment on physical impairment associated with poststroke depression: is there a time-related therapeutic window? J Nerv Ment Dis. 2003;191(10):645–52.

    Article  PubMed  Google Scholar 

  23. Robinson RG, Bolla-Wilson K, Kaplan E, Lipsey JR, Price TR. Depression influences intellectual impairment in stroke patients. Br J Psychiatry. 1986;148:541–7.

    Article  PubMed  CAS  Google Scholar 

  24. Spalletta G, Guida G, De Angelis D, Caltagirone C. Predictors of cognitive level and depression severity are different in patients with left and right hemispheric stroke within the first year of illness. J Neurol. 2002;249(11):1541–51.

    Article  PubMed  Google Scholar 

  25. Downhill Jr JE, Robinson RG. Longitudinal assessment of depression and cognitive impairment following stroke. J Nerv Ment Dis. 1994;182(8):425–31.

    Article  PubMed  Google Scholar 

  26. Morris PL, Robinson RG, Raphael B. Prevalence and course of depressive disorders in hospitalized stroke patients. Int J Psychiatry Med. 1990;20(4):349–64.

    Article  PubMed  CAS  Google Scholar 

  27. Starkstein SE, Robinson RG, Price TR. Comparison of patients with and without poststroke major depression matched for size and location of lesion. Arch Gen Psychiatry. 1988;45(3):247–52.

    Article  PubMed  CAS  Google Scholar 

  28. Bolla-Wilson K, Robinson RG, Starkstein SE, Boston J, Price TR. Lateralization of dementia of depression in stroke patients. Am J Psychiatry. 1989;146(5):627–34.

    PubMed  CAS  Google Scholar 

  29. Kimura M, Robinson RG, Kosier JT. Treatment of cognitive impairment after poststroke depression : a double-blind treatment trial. Stroke. 2000;31:1482–6.

    Article  PubMed  CAS  Google Scholar 

  30. Narushima K, Chan KL, Kosier JT, Robinson RG. Does cognitive recovery after treatment of poststroke depression last? A 2-year follow-up of cognitive function associated with poststroke depression. Am J Psychiatry. 2003;160(6):1157–62.

    Article  PubMed  Google Scholar 

  31. Morris PL, Robinson RG, Samuels J. Depression, introversion and mortality following stroke. Aust N Z J Psychiatry. 1993;27(3):443–9.

    Article  PubMed  CAS  Google Scholar 

  32. House A, Knapp P, Bamford J, Vail A. Mortality at 12 and 24 months after stroke may be associated with depressive symptoms at 1 month. Stroke. 2001;32(3):696–701.

    Article  PubMed  CAS  Google Scholar 

  33. Williams LS, Ghose SS, Swindle RW. Depression and other mental health diagnoses increase mortality risk after ischemic stroke. Am J Psychiatry. 2004;161(6):1090–5.

    Article  PubMed  Google Scholar 

  34. Lipsey JR, Robinson RG, Pearlson GD, Rao K, Price TR. Nortriptyline treatment of post-stroke depression: a double-blind study. Lancet. 1984;1(8372):297–300.

    Article  PubMed  CAS  Google Scholar 

  35. Andersen G, Vestergaard K, Lauritzen L. Effective treatment of poststroke depression with the selective serotonin reuptake inhibitor citalopram. Stroke. 1994;25(6):1099–104.

    Article  PubMed  CAS  Google Scholar 

  36. Robinson RG, Schultz SK, Castillo C, Kopel T, Kosier JT, Newman RM, et al. Nortriptyline versus fluoxetine in the treatment of depression and in short-term recovery after stroke: a placebo-controlled, double-blind study. Am J Psychiatry. 2000;157(3):351–9.

    Article  PubMed  CAS  Google Scholar 

  37. Rampello L, Alvano A, Chiechio S, Raffaele R, Vecchio I, Malaguarnera M. An evaluation of efficacy and safety of reboxetine in elderly patients affected by “retarded” post-stroke depression. A random, placebo-controlled study. Arch Gerontol Geriatr. 2005;40(3):275–85.

    Article  PubMed  CAS  Google Scholar 

  38. Chen Y, Guo JJ, Zhan S, Patel NC. Treatment effects of antidepressants in patients with post-stroke depression: a meta-analysis. Ann Pharmacother. 2006;40(12):2115–22.

    Article  PubMed  CAS  Google Scholar 

  39. Hackett ML, Anderson CS, House AO. Interventions for treating depression after stroke. Cochrane Database Syst Rev. 2004;3:1–48.

    Google Scholar 

  40. Masand P, Murray GB, Pickett P. Psychostimulants in post-stroke depression. J Neuropsychiatry Clin Neurosci. 1991;3(1):23–7.

    PubMed  CAS  Google Scholar 

  41. Lazarus LW, Moberg PJ, Langsley PR, Lingam VR. Methylphenidate and nortriptyline in the treatment of poststroke depression: a retrospective comparison. Arch Phys Med Rehabil. 1994;75(4):403–6.

    Article  PubMed  CAS  Google Scholar 

  42. Grade C, Redford B, Chrostowski J, Toussaint L, Blackwell B. Methylphenidate in early poststroke recovery: a double-blind, placebo-controlled study. Arch Phys Med Rehabil. 1998;79(9):1047–50.

    Article  PubMed  CAS  Google Scholar 

  43. Lincoln NB, Flannaghan T. Cognitive behavioral psychotherapy for depression following stroke: a randomized controlled trial. Stroke. 2003;34(1):111–5.

    Article  PubMed  CAS  Google Scholar 

  44. Williams LS, Kroenke K, Bakas T, Plue LD, Brizendine E, Tu W, et al. Care management of poststroke depression: a randomized, controlled trial. Stroke. 2007;38(3):998–1003.

    Article  PubMed  Google Scholar 

  45. Joubert J, Joubert L, Reid C, Barton D, Cumming T, Mitchell P, et al. The positive effect of integrated care on depressive symptoms in stroke survivors. Cerebrovas Dis. 199;26(2).

    Google Scholar 

  46. Jorge RE, Robinson RG, Tateno A, Narushima K, Acion L, Moser D, et al. Repetitive transcranial magnetic stimulation as treatment of poststroke depression: a preliminary study. Biol Psychiatry. 2004;55(4):398–405.

    Article  PubMed  Google Scholar 

  47. Kim D-Y, Lim J-Y, Kang EK, You DS, Oh M-K, Oh B-M, et al. Effect of transcranial direct current stimulation on motor recovery in patients with subacute stroke. Am J Phys Med Rehabil. 2010;89(11):879–86.

    Article  PubMed  Google Scholar 

  48. Murray GB, Shea V, Conn DK. Electroconvulsive therapy for poststroke depression. J Clin Psychiatry. 1986;47(5):258–60.

    PubMed  CAS  Google Scholar 

  49. Palomaki H, Kaste M, Berg A, Lonnqvist R, Lonnqvist J, Lehtihalmes M, et al. Prevention of poststroke depression: 1 year randomised placebo controlled double blind trial of mianserin with 6 month follow up after therapy. J Neurol Neurosurg Psychiatry. 1999;66(4):490–4.

    Article  PubMed  CAS  Google Scholar 

  50. Rasmussen A, Lunde M, Poulsen DL, Sorensen K, Qvitzau S, Bech P. A double-blind, placebo-controlled study of sertraline in the prevention of depression in stroke patients. Psychosomatics. 2003;44(3):216–21.

    Article  PubMed  CAS  Google Scholar 

  51. Almeida OP, Waterreus A, Hankey GJ. Preventing depression after stroke: results from a randomized placebo-controlled trial. J Clin Psychiatry. 2006;67(7):1104–9.

    Article  PubMed  Google Scholar 

  52. Robinson RG, Jorge R, Moser D, Acion L, Solodkin A, Small SL, et al. Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial. JAMA. 2008;28:2391–400.

    Article  Google Scholar 

  53. Narushima K, Kosier JT, Robinson RG. Preventing poststroke depression: a 12-week double-blind randomized treatment trial and 21-month follow-up. J Nerv Ment Dis. 2002;190(5):296–303.

    Article  PubMed  Google Scholar 

  54. Jorge RE, Robinson RG, Arndt S, Starkstein S. Mortality and poststroke depression: a placebo-controlled trial of antidepressants. Am J Psychiatry. 2003;160(10):1823–9.

    Article  PubMed  Google Scholar 

  55. Yi ZM, Liu F, Zhai SD. Fluoxetine for the prophylaxis of poststroke depression in patients with stroke: a meta-analysis. Int J Clin Pract. 2010;64(9):1310–7.

    Article  PubMed  CAS  Google Scholar 

  56. Anderson CS, Hackett ML, House A. Interventions for preventing depression after stroke. Cochrane Database Syst Rev. 2004;2:1–55.

    Google Scholar 

  57. Ramasubbu R. Therapy for prevention of post-stroke depression. Expert Opin Pharmacother. 2011;12(14):2177–87.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, 6009, Australia

    Sergio E. Starkstein, Simone Brockman & Brad Hayhow

  2. Fremantle Hospital, T-7, Fremantle, WA, 6959, Australia

    Sergio E. Starkstein

Authors
  1. Sergio E. Starkstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Simone Brockman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brad Hayhow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sergio E. Starkstein .

Editor information

Editors and Affiliations

  1. , Serviço de Neurologia, Hospital de Santa Maria, Av. Prof. Egas Moniz, Lisboa, 1649-035, Portugal

    José M. Ferro

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Starkstein, S.E., Brockman, S., Hayhow, B. (2013). Depression After Stroke. In: Ferro, J. (eds) Neuropsychiatric Symptoms of Cerebrovascular Diseases. Neuropsychiatric Symptoms of Neurological Disease. Springer, London. https://doi.org/10.1007/978-1-4471-2428-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2428-3_3

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2427-6

  • Online ISBN: 978-1-4471-2428-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation