Depresja poudarowa

• Authors: Adam Wysokiński

Title variants

EN

Post-stroke depression

• Languages of publication: EN PL

Abstracts

EN

Post-stroke depression is considered to be the most frequent neuropsychiatric brain stroke complication. It is defined as a depressive episode (with clinical picture similar to that of endogenous depression) that develops in the causal and temporal relation with a history of stroke (either haemorrhagic or ischaemic). The incidence of post-stroke depression ranges from 20% to 80%, and vast evidence suggests that this type of depression is still diagnosed not frequently enough and undertreated. In most patients, the symptoms of depression develop within 3–6 months following stroke. The prognosis depends on the severity of these symptoms – within two years after stroke remission is observed in the case of 30% (in the case of milder depression) to 75% (in the case of more severe depression) of the patients. Post-stroke depression significantly affects the course and the effectiveness of rehabilitation, the quality of life, locomotor improvement, daily activity, social functioning and interpersonal relations, and also significantly increases mortality (the risk of death within 10 years after stroke is more than threefold in patients with post-stroke depression compared with people who had stroke without depression). Biological and psychosocial factors are involved in the development of post-stroke depression. As indicated by the results of studies, antidepressants and psychostimulants are not only able to alleviate the symptoms of post-stroke depression, but perhaps they may also prevent its development. Further research is necessary regarding the pathophysiology of post-stroke depression and new methods of its treatment and prevention.

PL

Depresja poudarowa jest uznawana za najczęstsze neuropsychiatryczne powikłanie udaru mózgu. Definiuje się ją jako epizod depresyjny (o obrazie zbliżonym do epizodu depresji endogennej), który rozwija się w związku przyczynowym i czasowym z przebytym udarem mózgu, krwotocznym lub niedokrwiennym. Częstość występowania depresji poudarowej wynosi 20–80%, a liczne dowody wskazują na to, że choroba jest zbyt rzadko rozpoznawana i leczona. U większości pacjentów objawy depresji rozwijają się w ciągu 3–6 miesięcy po udarze. Rokowanie zależy od nasilenia tych objawów: w ciągu 2 lat od udaru remisję osiąga od 30% (w przypadku mniejszego nasilenia) do 75% pacjentów (w przypadku dużego nasilenia). Depresja poudarowa w znacznym stopniu wpływa na przebieg i skuteczność rehabilitacji, jakość życia, poprawę sprawności ruchowej, codzienną aktywność oraz funkcjonowanie społeczne i relacje interpersonalne, a także istotnie zwiększa śmiertelność – u osób z depresją poudarową ryzyko zgonu w ciągu 10 lat od udaru jest ponad trzykrotnie większe niż u tych, u których po udarze depresja nie wystąpiła. W rozwoju depresji poudarowej biorą udział czynniki biologiczne i psychospołeczne. Jak wskazują wyniki badań, leki przeciwdepresyjne i psychostymulujące są w stanie nie tylko łagodzić nasilenie objawów depresji poudarowej, lecz także – być może – zapobiegać jej rozwojowi. Konieczne są dalsze badania w zakresie patofizjologii tej choroby oraz nowych metod leczenia i profilaktyki.

Keywords

EN

depresja; depression; osoby starsze; stroke; the elderly; udar mózgu

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Psychiatria i Psychologia Kliniczna
• Year: 2016
• Volume: 16
• Issue: 3
• Pages: 171–175

Contributors

author

Adam Wysokiński

• Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych, Centralny Szpital Kliniczny, ul. Czechosłowacka 8/10, 92-216 Łódź, tel.: [phone], faks: [phone]

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• Document Type: review