Diagnosis, Management, Prevention, and Differential Diagnostic of Post Stroke Depression (PSD)

Abstract

Post-Stroke Depression (PSD) is a common psychiatric symptom after stroke. PSD is a condition in which stroke patients
experience traumatic events that damage their physical and mental integrity, autonomy and self-esteem, and social values.
Lack of psychological coping mechanisms, as well as premorbid personality, are determinants of PSD. PSD patients mostly
present with fluctuation in mood, retardation, irritability, or apathy. PSD is a major factor that can inhibit the recovery of
neurological function and daily activities in stroke patients, and is associated with increased mortality. A recent meta-analysis
showed
that
the
prevalence
of
Post-Stroke
Depression
(PSD)
was
29%.
PSD
deals
with
the
disruption
of
monoamine

circuits

either directly or indirectly. In cytokine theory, inflammation of PSD may be related to the production of
“depressogenic” cytokines by the inflammatory response to ischemia. This may be related given that inflammatory
cytokines, such as IL-1, IL-6, IL-18, and tumor necrosis factor (TNF) -alpha increase significantly after stroke. Biological and
psychological conditions cause PSD either due to lesions, biogenic amines, inflammatory cytokines, or genetic
polymorphisms. PSD must be distinguishable from post-stroke apathy, post-stroke anxiety (PSA), post-stroke fatigue (PSF),
and post-stroke psychotic disorder (PSPD). The goal of PSD treatment is to achieve complete remission of the symptoms of
a depressive episode, which may have a beneficial impact on the recovery of neurological deficits. Management can be
done with pharmacological and non-pharmacological interventions in the form of neuromodulation and psychosocial. The
The purpose of this article is to provide information regarding the Post-Stroke Depression (PSD).