Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-09T22:37:28.111Z Has data issue: false hasContentIssue false
  • English
  • Français

Frequency, phenomenology and anatomical–clinical correlates of major post-stroke depression

Published online by Cambridge University Press:  03 January 2018

G. Gainotti ,
A. Azzoni  and
C. Marra
G. Gainotti*
Affiliation:
Instruite of Neurology, Catholic University of Rome, Rome, and IRCCS, Clinica S. Lucia, Rome
A. Azzoni
Affiliation:
Psychiatric Service, Ospedale S. Spirito, Rome
C. Marra
Affiliation:
Institute of Neurology, Catholic University of Rome, Rome, Italy
*
G. Gainotti, Catholic University of Rome, L. go A. Gemelli 8, 00168 Rome, Italy. Tel: +39 6 3015 4333; Fax: +39 6 3550 1909; e-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The meaning of post-stroke depression is controversial.

Aims

To investigate the hypothesis that major post-stroke depression (PSD) may be due to organic factors (left frontal lesions) immediately after the stroke, but to psychosocial factors in later stages.

Method

We studied 153 consecutive stroke patients, categorised on the basis of time elapsed since stroke, lesion location and presence/absence of major PSD, Fifty-eight were examined in the first two months following the stroke, 52 between two and four months, and 43 after four months or more. The symptom profiles and anatomical–clinical correlates of major PSD were studied in each subgroup. A group of 30 patients affected by a functional form of major depression were also investigated.

Results

The symptom profiles and anatomical–clinical correlates of major PSD were not different in the acute and more chronic stages. Clear symptom differences were, however, observed between major PSD and endogenous major depression. Motivated (reactive) symptoms prevailed in the former, whereas unmotivated symptoms prevailed in the latter.

Conclusions

Our data are more consistent with a psychological than with a neurological model of post-stroke depression.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 2 , August 1999 , pp. 163 - 167
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Åstram, M., Adolfsson, R. & Asplund, K. (1993) Major depression in stroke patients. Three year longitudinal study. Stroke, 24, 976–982.CrossRefGoogle Scholar
Dam, H., Pedersen, H. E. & Ahlgren, P. (1989) Depression among patients with stroke. Acta Psychiatrica Scandinavica, 80, 118–124.Google Scholar
Darnaslo, H. & Damasio, A. R. (1989) Lesion Analysis in Neuropsychology. New York: Oxford University Press.Google Scholar
Gainotti, G., Azzoni, A., Razzano, C., et al (1997a) The Post-Stroke Depression Rating Scale: a test specifically devised to investigate affective disorders of stroke patients. Journal of Clinical Experimental Neuropsychology, 19, 340–356.CrossRefGoogle Scholar
Gainotti, G., Azzoni, A., Gasparini, F., et al (1997b) Relation of lesion location to verbal and non verbal mood measures in stroke patients. Stroke, 28, 2145–2149.Google Scholar
Hamilton, H. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Herrmann, M. & Wallesch, C. W. (1993) Depressive changes in stroke patients. Disability Rehabilitation, 15, 55–66.CrossRefGoogle ScholarPubMed
Herrmann, M., Bartels, C., Shumacher, M., et al (1995) Post-stroke depression: is there a pathoanatomical correlate for depression following the postacute stage of stroke? Stroke, 26, 850–856.Google Scholar
House, A., Dennis, M., Warlow, C., et al (1990) Mood disorders after stroke and their relation to lesion location: a CT scan study. Brain, 113, 1113–1190.Google Scholar
Lipsey, J. R., Robinson, R. G., Pearlson, G. D., et al (1984) Nortriptyline treatment of post stroke depression: a double-Wind study. Lancet, i, 297–300.Google Scholar
Robinson, R. G., Kubos, K. L., Rao, K., et al (1983) Mood changes in stroke patients: relationship to lesion location. Comprehensive Psychiatry, 24, 555–566.CrossRefGoogle ScholarPubMed
Robinson, R. G., Kubos, K. L., Rao, K., et al (1984) Mood disorders in stroke patients: importance of location of lesion. Brain, 107, 81–93.Google Scholar
Robinson, R. G. & Starkstein, S. E. (1989) Mood disorders following stroke: new findings and future directions. Journal of Geriatric Psychiatry, 22, 1–15.Google Scholar
Salzman, C., Schneider, L. S. & Alexopulos, E. S. (1994) Pharmacological treatment of depression in late life, In Psychopharmocology: fourth Generation of Progress (eds Bloom, F. E. & Kupfer, D. J.). pp. 1471–1477. New York: Raven Press.Google Scholar
Sinyor, D., Jaques, P., Kaloupek, D. G., et al (1986) Post stroke depression and lesion location: an attempted replication. Brain, 109, 537–546.Google Scholar
Starkstein, S. E., Robinson, R. G. & Price, T. R. (1987) The comparison of cortical and subcortical lesions in the production of post-stroke mood disorders. Brain, 110, 1045–1059.Google Scholar
Starkstein, S. E. & Robinson, R. G. (1988) Aphasia and depression. Aphasiology, 2, 1–20.Google Scholar
Starkstein, S. E. & Robinson, R. G. (1989) Affective disorders and cerebral vascular disease. British Journal of Psychiatry, 154, 170–182.Google Scholar
Stern, R. A. & Bachman, D. L. (1991) Depressive symptoms following stroke. American Journal of Psychiatry, 148, 351–356.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.