Skip to main content
SpringerLink
Log in

Post-stroke depression

  • Section V Special Patient Groups
  • Published:
Psychopharmacology Aims and scope Submit manuscript

Abstract

Depression is present in 25–30% of stroke patients: though associated with physical disability and loss of function, it cannot be explained simply as a response to the disability. The severity of depression correlates with proximity of the lesion to the left anterior frontal pole, while right hemisphere lesions show the reverse trend. Post-stroke depressions may last more than 7–8 months without treatment, and are highly correlated with a failure to resume premorbid social and physical activities. However, this is a group of patients whose recovery could be hastened by appropriate antidepressant treatment, though most antidepressants are of limited value in the treatment of these patients, because of side-effects or possible toxicity. Since moclobemide has few side-effects it may be uniquely well tolerated in this group of patients, having proven efficacy for both endogenous and reactive depressions.

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

Access this article

Log in via an institution

Price includes VAT (Hong Kong/P.R.China)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahlsio B, Britton M, Murray V, Theorell T (1984) Disablement and quality of life following stroke. Stroke 15:886–890

    Google Scholar 

  • Adams GF, Hurwitz LJ (1968) Mental barriers to recovery from strokes. Lancet ii:533–537

    Google Scholar 

  • Adams GF, Hurwitz LJ (1974) Cerebrovascular disability and the ageing brain. Churchill Livingston, Edinburgh and London

    Google Scholar 

  • American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  • American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn. Revised. American Psychiatric Association, Washington, DC

    Google Scholar 

  • Babinski MJ (1914) Contribution à l'étude des troubles mentaux dans l'hemiplegie organique cérébrale (anosognosie). Rev Neurol 27:845–848

    Google Scholar 

  • Bell DS (1966) Psychiatric aspects of cerebral vascular disease. Med J Aust 2:829–833

    Google Scholar 

  • Bisiach E, Vallar G, Perani D, Papagno C, Berti A (1986) Unawareness of disease following lesions of the right hemisphere: anosognosia for hemiplegia and anosognosia for hemianopia. Neuropsychologia 24:471–482

    Google Scholar 

  • Black DW (1982) Pathological laughter: a review of the literature. J Nerv Ment Dis 170:67–71

    Google Scholar 

  • Blumer D, Benson DF (1975) Personality changes with frontal and temporal lobe lesions. In: Benson DF, Blumer D (eds) Psychiatric aspects of neurologic disease. Grune and Stratton, New York, pp 151–169

    Google Scholar 

  • Davison K, Bagley CR (1969) Schizophrenia-like psychoses associated with organic disorders of the central nervous system: a review of the literature. In: Herrington RN (ed) Current problems in neuropsychiatry. British Journal of Psychiatry Special Publication No. 4. Headley Brothers, Ashford, pp 113–185

    Google Scholar 

  • Eastwood MR, Rifat SL, Nobbs H, Ruderman J (1989) Mood disorder following cerebrovascular accident. Br J Psychiatry 154:195–200

    Google Scholar 

  • Ebrahim S, Barer D, Nouri F (1987) Affective illness after stroke. Br J Psychiatry 151:52–56

    Google Scholar 

  • Feibel JH, Berk S, Joynt RJ (1979) The needs of stroke survivors. Neurology 29:592

    Google Scholar 

  • Folstein MF, Mailberger R, McHugh PR (1977) Mood disorder as a specific complication of stroke. J Neurol Neurosurg Psychiatry 40:1018–1020

    Google Scholar 

  • Gianotti G (1972) Emotional behaviour and hemispheric side of lesion. Cortex 41–55

  • Goldstein K (1948) Language and language disturbances. Grune and Stratton, New York

    Google Scholar 

  • Harris AI, Cox E, Smith CRW (1971) Handicapped and impaired in Great Britain, Part I. Office of Population Censuses and Surveys, HMSO, London, p 450

    Google Scholar 

  • House A (1987a) Depression after stroke. BMJ 294:76–78

    Google Scholar 

  • House A (1987b) Mood disorders after stroke: a review of the evidence. Int J Geriatr Psychiatry 2:211–221

    Google Scholar 

  • Karliner W (1978) ECT for patients with CNS disease. Psychosomatics 19:781–783

    Google Scholar 

  • Labi M (1980) Psychosocial disability in physically restored long-term stroke survivors. Arch Phys Med Rehabil 61:561–565

    Google Scholar 

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

    Google Scholar 

  • Lipsey JR, Spencer WC, Rabins PV, Robinson RG (1986) Phenomenological comparison of post-stroke depression and functional depression. Am J Psychiatry 143:527–529

    Google Scholar 

  • Lishman WA (1978) Cerebrovascular disorders. In: Lishman WA (ed) Organic psychiatry: the psychological consequences of cerebral disorder. Blackwell, Oxford, pp 459–464

    Google Scholar 

  • Moffic HS, Paykel ES (1975) Depression in medical in-patients. Br J Psychiatry 126:346–353

    Google Scholar 

  • Paykel ES (1971) Depressive typologies and response to amitripty-line. Br J Psychiatry 119:555–564

    Google Scholar 

  • Poeck K (1969) Pathophysiology of emotional disorders associated with brain damage. In: Vinken PJ, Bruyen GW (eds) Handbook of clinical neurology. Elsevier, North Holland

    Google Scholar 

  • Post F (1962) Significance of affective symptoms in old age. Maudsley Monograph no. 10. Oxford University Press, London

    Google Scholar 

  • Robinson RG, Price TR (1982) Post-stroke depressive disorders: a follow-up study of 103 patients. Stroke 13:635–641

    Google Scholar 

  • Robinson RG, Szetela B (1981) Mood change following left hemisphere brain injury. Ann Neurol 9:447–453

    Google Scholar 

  • Robinson RG, Starr LB, Kubos KL, Price TR (1983) A two year longitudinal study of post-stroke mood disorders: findings during the initial evaluation. Stroke 14:736–741

    Google Scholar 

  • Robinson RG, Starr LB, Price TR (1984a) A two year longitudinal study of mood disorders following stroke: prevalence and duration at six months follow-up. Br J Psychiatry 144:256–262

    Google Scholar 

  • Robinson RG, Kubos KL, Starr LB, Rao K, Price TR (1984b) Mood disorders in stroke patients: importance of location of lesion. Brain 107:81–93

    Google Scholar 

  • Robinson RG, Starr LB, Lipsey JR, Rao K, Price TR (1984c) A 2 year longitudinal study of post-stroke mood disorders: dynamic changes in associated variables over the first 6 months of follow up. Stroke 15:512–517

    Google Scholar 

  • Robinson RG, Bolduc PL, Kubos KL, Starr LB, Price TR (1985) Social functioning assessment in stroke patients. Arch Phys Med Rahbil 66:496–500

    Google Scholar 

  • Robinson RG, Bolla Wilson K, Kaplan E, Lipsey JR, Price TR (1986) Depression influences intellectual impairment in stroke patients. Br J Psychiatry 148:541–547

    Google Scholar 

  • Ross ED, Stewart RS (1987) Pathological display of affect in patients with depression and right frontal brain damage: an alternative mechanism. J Nerv Ment Dis 175:165–172

    Google Scholar 

  • Roth M (1955) The natural history of mental disorder in old age. J Ment Sci 155:281–301

    Google Scholar 

  • Sinyor D, Jacques P, Kaloupek DG, Becker R, Goldenberg M, Coopersmith H (1986a) Post-stroke depression and lesion location: an attempted replication. Brain 109:537–529

    Google Scholar 

  • Sinyor D, Amato P, Kaloupek DG, Becker R, Goldenberg M, Coopersmith H (1986b) Post-stroke depression: relationships to functional impairment, coping strategies and rehabilitation outcome. Stroke 17:1102–1107

    Google Scholar 

  • Starkstein SE, Robinson RG, Price TR (1987) Comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain 110:1045–1059

    Google Scholar 

  • Starkstein SE, Boston JD, Robinson RG (1988a) Mechanisms of mania after brain injury: 12 case reports and review of the literature. J Nerv Ment Dis 176:87–100

    Google Scholar 

  • Starkstein SE, Robinson RG, Price TR (1988b) Comparison of patients with and without post-stroke major depression matched for size and location of lesion. Arch Gen Psychiatry 45:247–252

    Google Scholar 

  • Starkstein SE, Robinson RG, Berthier ML, Price TR (1988c) Depressive disorders following posterior circulation as compared with middle cerebral artery infarcts. Brain 111:375–387

    Google Scholar 

  • Wade DT, Leigh-Smith J, Hewer RA (1987) Depressed mood after stroke: a community study of its frequency. Br J Psychiatry 151:200–205

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Melbourne, The Royal Melbourne Hospital, 7th floor, Clinical Science Building, 3050, Melbourne, Victoria, Australia

    J. W. G. Tiller

Authors
  1. J. W. G. Tiller
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tiller, J.W.G. Post-stroke depression. Psychopharmacology 106 (Suppl 1), S130–S133 (1992). https://doi.org/10.1007/BF02246257

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02246257

Key words

Search

Navigation