• Title/Summary/Keyword: 뇌졸중 후 우울증

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A Case of Rapid Cycling Secondary Bipolar Disorder Following Rt. Hemisphere Cerebral Infarction in a Patient with Preceeded Left Hemisphere Poststroke Depression (좌반구 뇌졸중후 우울증 환자에서 우반구 뇌경색이 수반된 급속 순환형 이차성 양극성장애 1례)

  • Chang, Ho-Kyun;Yi, Ho-Taek;Paik, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.79-84
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    • 1998
  • Authors report a case of poststroke bipolar disorder that occurs much less frequently than poststroke depression(PSD). A MRI study performed to identify the etiology of a secondary manic episode in a patient with preceded PSD after left basal ganglia infarction revealed newly developed right basal ganglia infarction associated with poststroke bipolar disorder. It is interesting to note that (1) the temporal relationship was found between the occurrence of PSD after left hemisphere stroke and the occurrence of poststroke bipolar disorder following right hemisphere stroke, and that (2) the occurrence of PSD and the occurrence of poststroke bipolar disorder are associated with lesion location respectively. It has been reported that bipolar disorders were associated with subcortical lesions of the right hemisphere, whereas right-cortical lesions led to unipolar mania and that risk factors for mania included a family history of psychiatric disorders and mild subcortical atrophy. In this case, MR image shows subcortical lesions of the right hemisphere and mild subcortical atrophy. The investigation of the relationships among stroke lesion locations and potstroke mood disorders and risk factors for poststroke bipolar disorder may contribute to understanding the neurobiology of primary mood disorder. A clinical implication is that the risk of secondary bipolar disorder after cerebral infarction should be highlighted.

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Diagnosis and Treatment of Poststroke Depression (뇌졸중 후 우울증의 진단과 치료)

  • Kim, Jae-Min;Shin, Hee-Yung
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.89-97
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    • 2005
  • Depression is a frequently developed psychiatric symptom after stroke. Poststroke depression(PSD) causes not only psychological distress related to depression but also other disturbances in many areas such as cognitive function, activities of daily living and quality of life. Therefore, a comprehensive understanding of accurate detection and appropriate treatment of depression is mandatory in patients with stroke. This review focused on the current knowledge of PSD.

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The Effects of Cognitive Stimulation Circulative Program on the Depression and Social Cognitive Ability of Stroke Patients (뇌졸중 환자의 우울 및 사회인지 능력에 대한 인지자극순환프로그램의 효과)

  • Do, Ji-Hye;Kim, Eun-Joo
    • Journal of Digital Convergence
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    • v.17 no.6
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    • pp.439-446
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    • 2019
  • Poststroke depression can have a secondary effect on social cognition, and this can lead to behavioral problems. The purpose of this study was to verify the effects of a Cognitive Stimulation Circulative Program(CSCP) based on occupational therapy. The participants of this study were 12 stroke patients. The CSCP was organized in such a way to promote the cognitive process. This program were carried out as a circuit program(16 sessions). As a result of this study, the depression scale of the subjects had statistically significant benefit(p<.05). Also, the evaluation results verified partial improvement in quality of life, and the relationship change scale which was used to evaluate role of physical and social cognitive function ability had statistically significant benefit(p<.05). The above results of this study verified that the CSCP was an efficient intervention program that reduces the depression of stroke patients and improve their social cognitive function ability, thus enhancing the quality of life.

Effect of Virtual Reality Game on Old Patient's Depression, Relationship and Life Satisfaction (가상현실 게임이 노인 뇌졸중 환자의 우울, 대인관계, 삶의 만족도에 미치는 효과)

  • Shin, Kyung-Eun;Oh, Myung-Hwa;Chung, Hyun-Ae;Kim, Hee-Dong
    • 재활복지
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    • v.21 no.4
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    • pp.101-118
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    • 2017
  • This study was conducted to investigate the effect of virtual reality game on old stroke patient's depression, relationship and life satisfaction. The subjects of this study were 40 stroke patients of over 65 years old and each 20 patients were randomly assigned in two groups. The study was conducted for 12 weeks. Nintendo Wii Sports Resort program was applied to the virtual reality game for the experimental group. In order to investigate psychological social factor (depression, relationship) and life satisfaction of the objects, BDI, RCS, LSI-Z were checked three times. The results are as followings. First, the psychological social change (depression, relationship) after the training program showed that depression is significantly decreased (p<.001) along with the intervention period in both 2 groups. Second, change of life satisfaction after the training program showed that significant statistical improvement were found both in control group(p<.05), and experimental group(p<.001). Third, depression, relationship showed the significant statistically correlation with life satisfaction(p<.05). We can conclude from the above that virtual reality games which were played by 2 persons had the significant effect on old stroke patient's psychological social factor(depression, relationship) and life satisfaction.

Correlations between Neurologic and Psychiatric Symptoms in Acute Stroke Patients (급성기 뇌졸중 환자에서 신경 및 정신 증상간 상호관계)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.98-104
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    • 2012
  • Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

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Prevalence and Risk Factors of Post-Stroke Depression (뇌졸중후우울증의 유병율 및 예측인자)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Kim, Joon-Tae;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Mood & Emotion
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    • v.9 no.2
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    • pp.57-63
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    • 2011
  • Objectives : This study aimed to investigate the prevalence and risk factors of depression within two weeks after stroke. Methods : A total of 362 stroke patients were recruited. Depression (major and minor depressive disorders) was diagnosed by applying DSM-IV criteria. Data on socio-demographic characteristics (age, gender, education, marital state, living state, religion, occupation, income, life event, and social support), stroke severity (NIHSS), disability (BI), stroke hemisphere and location, vascular risk and disease, and previous history of stroke and depression were obtained. Results : Depression was present in 90 (24.9%) patients: major depression 29 (8%) and minor depression 61 (16.9%) patients. In the univariate analyses, depression was associated with older age, higher number of stressful life event, poorer social support, severe disability, anterior stroke location, previous history of stroke and depression. In the multivariate analyses, depression was independently associated with higher number of stressful life events and poorer social support. Conclusion : Depression was common and was determined by premorbid levels of stress and social support in stroke patients at acute stage. More intensive psychiatric care and intervention is needed for the high risk group.

The Effect of Recovery of disability on Post-stroke Depression (뇌졸중 환자의 장애 회복이 뇌졸중 후 우울증에 미치는 영향)

  • Ha, Mi-Sook;Park, Min-Chull;Goo, Bong-Oh
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.4
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    • pp.623-632
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    • 2010
  • Purpose : The purpose of this study was to identify the effect of recovery of disability on post-stroke depression in stroke patients. Methods : Fifty patients with stroke were participated in this study. The stroke impact scale(SIS) was used to assess the recovery of disability according to stroke and short form of geriatric depression scale(SGDS) was used to assess the poststroke depression(PSD). Results : The suspicious for depression were exhibited in 38%(n=19) and patients with depression were 58% (n=26) of 50 patients with stroke. In correlation between recovery of disability and depression, emotion and recovery of stroke negatively correlated with depression(p<.05). Conclusion : These results demonstrates that patients with stroke need to manage and treat emotion for the prevention and management of PSD.

Significance of Dexamethasone Suppression Test in Patients with Stroke (뇌졸중 환자에서 Dexamethasone 억제검사의 의의)

  • Kim, Wook-Nyeon;Kim, Seong-Min;Kee, Beung-Su;Park, Mee-Young;Hah, Jung-Sang;Byun, Yeung-Ju
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.63-71
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    • 1994
  • The purpose of this study was to evaluate the effect of stroke on hypothalamic-pituitary axis using dexamethasone suppression test. The effects were evaluated according to age, sex, type, size, and lesion site of stroke. These tests were performed in 62 patients with stroke(cerebral infarction, 42 cases : intracerebral hemorrage, 20 cases) and 21 disabled controlled patients without intracranial diseases at Yeungnam University Hospital from June 1992 to June 1993. The results summarized as follows. 1. Cerebral infarction showed significantly higher frequency of DST non-suppression in stroke patients than control(p<0.05). 2. Patients with left hemisphere stroke showed more frequent abnormal neuroendocrine test results(p<0.01) 3. Patients with large infarction revealed strongly non-suppressed DST results(p<0.01). 4. Sinificantly higher basal cortisol level in patients with cerebral infarction was noted(p<0.01). 5. There are no statistical significance between DST results and sex, age, motor impairment, type of cerebral infarction.

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The correlation between post-stroke depression and the recovery rate of motor functions (뇌졸중후 우울증의 정도와 운동기능의 회복과의 상관관계에 대한 연구)

  • Park, Se-Jin;Park, Sang-Dong;Lee, Jeong-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.13 no.2
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    • pp.101-106
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    • 2002
  • Objectives : The degree of post-stroke depression was observed and then correlated to the recovery rate of the motor functions of the above treated stroke patients. Methods : The BDI SCALE(Beck Depression Inventory Scale) and motor grades of 50 diagnosed stroke patients who were hospitalized in Dong-Seo Oriental Hospital between the period of May 2002 to September 2002 were measured. After a 1 month recovery period the BDI SCALE and motor grade of the above mentioned patients were again measured and a correlation was observed. Results : A lower BDI SCALE was observed in patients with a higher motor grade recovery rate. Conclusion : The treatment of post-stroke depression is imperative for positive effects on the motor functions of stroke patients.

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The Clinical pilot study of Hwangryunhaedok-tang Pharmacopunctue therapy on Post-stroke depression (뇌졸중 후 우울증에 대한 황련해독탕 약침의 안전성 및 유효성 평가를 위한 임상 시험)

  • Je, Jun-Tae;Lee, Sang-Kwan
    • Journal of Pharmacopuncture
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    • v.13 no.2
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    • pp.67-73
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    • 2010
  • Objective : The purpose of this study is to determine the efficacy and safely of Hwangryunhaedok-tang Pharmacopuncture (HHT-PA) therapy on post-stroke depression (PSD) in stroke patients. Methods : Fifteen PSD patients has been recruited and evaluated with liver function test (LFT) and renal function lest (RFT) and depression scales, Beck Depress ion Inventory (BDI) and Hamilton Depression Rating Scale (HAM-D) before and after HHT-PA treatment. Results : HAM-D score significantly decreased after HHT-PA treatment regard less of improving of motor function. But BDI score did not decrease significantly. All results of LFT and RFT were in normal range before and after HHT-PA treatment Conclusion : These results showed that HHT-PA decrease PSD symptoms and has safety on stroke patients, although has no effect on improving of motor impairment.