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Semin Neurol 2005; 25(4): 396-409
DOI: 10.1055/s-2005-923534
Published 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Depression and Stroke: Cause or Consequence?

Linda S. Williams1
  • 1Center for Implementing Evidence-Based Practice, Roudebush VAMC; Associate Professor, Neurology, Indiana University School of Medicine; Research Scientist, Regenstrief Institute, Inc., Indianapolis, Indiana
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Publication History

Publication Date:
08 December 2005 (online)

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ABSTRACT

Depression after stroke is common. Although different opinions exist about the definition, diagnosis, and measurement of outcomes related to depression after stroke, there is little debate about the prevalence of depression symptoms and their impact on stroke survivors and their families. Depression after stroke has long been recognized as a common condition with many negative effects in the poststroke period, but more recently depression has also been identified as an independent stroke risk factor. Given that there are at least 500,000 new ischemic strokes yearly in the United States, a conservative estimate is that 150,000 U.S. stroke survivors develop poststroke depression each year. Because effective treatments exist but are likely underutilized for depression, this is an important example of an evidence-practice gap to which increased efforts to improve care should be made. Such efforts would likely improve not only patient symptoms but may also decrease stroke risk, influence stroke functional recovery, decrease mortality, and reduce poststroke health care utilization. This article provides an overview of depression diagnosis in stroke, reviews the epidemiology of poststroke depression and its associated morbidity and mortality, and reviews existing evidence on the treatment and prevention of poststroke depression.

KEYWORDS

Stroke - depression - recovery - risk factors

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Linda S WilliamsM.D. 

Health Services Research Center (11H) Neurology

Roudebush VA Medical Center, 1481 West 10th Street

Indianapolis, IN 46202

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