Every year, about 16 million people worldwide have a first ever stroke. Of this population, about 5 -7 million people die. Among the survivors, depression occurs in approximately 1/3. The pathophysiology of post-stroke depression (PSD) is poorly understood; proposed mechanisms include psychological responses to functional disability, social mal-adaptation, genetic susceptibility and alterations in neurotransmitter due to brain damage. Important predictors of PSD include physical disability, depression before stroke, and cognitive impairment. Individuals with PSD have higher healthcare use, poorer functional outcomes and quality of life, and higher mortality. Pharmaceutical treatment (selective serotonin-reuptake inhibitors or tricyclic antidepressants), psychosocial intervention, and, preferably, both are helpful in improving patients’ depressive symptoms.
Considering the high prevalence of PSD, its negative impact on patients’ outcome, and treatability of this problem, medical personnel should be aware of the PSD, and should promptly screen depressive symptoms and apply evidence-based management. Unfortunately, PSD has been underrecognized, underinvestigated, and undertreated.
One of the missions of WSO is to educate health care personnel in every corner of the world this important problem and help them to facilitate research so that we can more clearly understand the pathophysiology of PSD and determine optimal strategies to prevent and treat this condition.
Jong S. Kim, on behalf of WSO and Associate Editor for the International Journal of Stroke
