Poststroke depression: An examination of the literature

Objective: To examine literature on poststroke depression (PSD). Data Sources: More than 200 articles related to stroke and depression were selected from a computer-based search spanning 1985 to 1995. Study Selection: All relevant articles on PSD. Articles in foreign languages, case studies, anecdotal reports, book chapters, and reviews were excluded. Data Extraction: Summary findings were independently reviewed by the authors. Data Synthesis: PSD remains a frequent sequela of stroke; its prevalence remains uncertain because of continued methodologic problems in defining subject groupings and in utilizing psychiatrically normed assessment tools with neurologically impaired individuals, and because of the poor specificity/sensitivity of neuroendocrine markers in determining a diagnosis. The etiology of PSD appears to be complex and not fully understood. Although there has been much research on PSD, this review highlights the sparsity of available literature on its treatment. Conclusion: The review points out the further need for more carefully designed studies of PSD that examine both assessment and treatment.