Diagnosis of depression after stroke Depression occurring after stroke (pos t-stroke depression, PSD) has been the object of many clinical studies (about 300 during the last 30 years). We will review the available data and discuss the clinical implications of the research conducted to date. Patients should be evaluated for PSD in the acute phase (Berg et al., 2001) in the first few months after stroke onset (Pohjasvaara et al., 1998), and before transfer in rehabilitation grounds (Paolucci et al., 1999; Gillen et al., 2001), to reduce disability, caregiver burden, and costs. Diagnostic criteria The DSM-IV-TR (American Psychiatric Association, 2001) defines universally adopted diagnostic criteria (Table 29.1). These criteria correspond to depression occurring with chronic medical conditions (e.g. chronic heart failure, hyperthyroidism, and others), including stroke. The only feature distinguishing PSD from endogenous depression (ED) is a persistent depressed mood that is judged to be due to the direct physiological effects of a general medical condition. The ICD-10 diagnostic criteria for an organic depressive disorder are comparable to DSM-IV criteria. DSM-IV diagnostic criteria for a major depressive episode require the persistence of symptoms for at least two weeks. Thus, in many cases PSD cannot be formally diagnosed in an acute care setting.
|Title of host publication||The Behavioral and Cognitive Neurology of Stroke|
|Publisher||Cambridge University Press|
|Number of pages||23|
|ISBN (Print)||9780511544880, 0521842611, 9780521842617|
|Publication status||Published - Jan 1 2007|
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