• Title/Summary/Keyword: poststroke depression

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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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Cytoprotective action of Rubi Fructus by modulation of Reactive Oxygen Species, peroxynitrite and $Ca^{2+}$ (복분자(覆盆子)의 세포내 ROS, $ONOO^-$ 생성 및 $Ca^{2+}$ 증가 억제에 의한 혈관내피세포 보호작용)

  • Lee, Cheol-Woong;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.615-625
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    • 2005
  • Objectives : Poststroke depression is a frequent and specific entity that impaires the rehabilliation and functional recovery of patients with hemiplegia. The author evaluated the effect of Banhahubak-tang(Banxiahoupotang) in patients with poststroke depression. Methods : 38 patients suffering from poststroke depression(determined by Diagnostic and Statistical Manual of Mental Disorders, revised. 3rd edition. and Beck Depression Inventory[BDI] cutoff $point{\geqq}10$) in Kyunghee Oriental hospital were randomized into two groups; treatment group(n=19) and control group(n=19). The treatment group was prescribed with Banhahubak-tang(Banxiahoupotang) three times a day fur a week. Control troop was prescribed with other herbal medicines used for stroke Patients three times a day for a week. Patients were evaluated by use of BDI scale, Modified Barthel Index, Depression of Ki score, Yin syndrome score, and Yang syndrome score. Among 38 patients, 24 patients got BDI scores above 21, which is the cut-off score for depression in Korean. The same procedures and assessments described above were applied. Results : Treatment group did not significantly improve compared with control group. Results yielded only slight significance (P=0.086). Especially. patients with poststroke depression as yin syndrome improved more significantly on BDI than those classified as yang syndrome. When BDI cutoff point for depression was defined as being ${\geq}\;21$, treatment group did not significantly improve compared with control group(P=0.114). However, patients with poststroke depression classified as yin syndrome were also significantly improved on BDI than those classified as yang syndrome. Conclusions : This study suggests that Banhahubak-tang(Banxiahoupotang) is significantly effective in patients with poststroke depression classified as yin syndrome.

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Depression and Executive Dysfunction in Stroke (뇌졸중에서 우울증과 실행기능부전에 대한 고찰)

  • Na, Kyoung-Sae;Kim, Shin-Gyeom;Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.19 no.4
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    • pp.179-186
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    • 2012
  • Depression and executive dysfunction are common neuropsychiatric sequelae of stroke. Patients with stroke are more predisposed to depression and executive dysfunction compared to patients with similar degree of physical disability. Both depression and executive dysfunction are also associated with poor prognosis such as high mortality and delayed recovery after stroke. Complex neurobiological and anatomical mechanisms are associated with the development of depression and executive dysfunction after stroke. Activation of pro-inflammatory cytokines is thought to be associated with onset of depression, whereas injuries in frontal-subcortical circuit are thought to be a link between depression and executive dysfunction. Early detection of depressive symptoms and both pharmacological and non-pharmacological treatment would be helpful. In this review paper, the authors investigated 1) biological and neuroanatomical substrate for poststroke depression and executive dysfunction, 2) the relationship and common etiopathology for poststroke depression and executive dysfunction, and 3) pharmacological and non-pharmacological treatment for poststroke depression. The contents of the paper are as follows : the prevalence, clinical manifestation, and biological etiology for poststroke depression, neuroanatomical abnormalities as a common etiological factor for depression and executive dysfunction, pharmacotherapy and non-pharmacological approach.

Effects of Banhahubak-tang(Banxiahoupotang) on patients with poststroke depression (중풍후우울증에 대한 반하후박탕의 유효성 및 적응증 평가)

  • Jung, Jae-Han;Choi, Chang-Min;Hong, Jin-Woo;Kim, Tae-Hun;Rhe, Jun-Woo;Lee, Cha-Ro;Bahn, Geon-Ho;Jung, Woo-Sang;Moon, Sang-Kwan;Bae, Hyung-Sup;Na, Byong-Jo
    • The Journal of Internal Korean Medicine
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    • v.26 no.3
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    • pp.563-574
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    • 2005
  • Objectives : Poststroke depression is a frequent and specific entity that impaires the rehabilliation and functional recovery of patients with hemiplegia. The author evaluated the effect of Banhahubak-tang(Banxiahoupotang) in patients with poststroke depression. Methods : 38 patients suffering from poststroke depression(determined by Diagnostic and Statistical Manual of Mental Disorders, revised. 3rd edition. and Beck Depression Inventory[BDI] cutoff $point{\geqq}10$) in Kyunghee Oriental hospital were randomized into two groups; treatment group(n=19) and control group(n=19). The treatment group was prescribed with Banhahubak-tang(Banxiahoupotang) three times a day fur a week. Control troop was prescribed with other herbal medicines used for stroke Patients three times a day for a week. Patients were evaluated by use of BDI scale, Modified Barthel Index, Depression of Ki score, Yin syndrome score, and Yang syndrome score. Among 38 patients, 24 patients got BDI scores above 21, which is the cut-off score for depression in Korean. The same procedures and assessments described above were applied. Results : Treatment group did not significantly improve compared with control group. Results yielded only slight significance (P=0.086). Especially. patients with poststroke depression as yin syndrome improved more significantly on BDI than those classified as yang syndrome. When BDI cutoff point for depression was defined as being ${\geq}\;21$, treatment group did not significantly improve compared with control group(P=0.114). However, patients with poststroke depression classified as yin syndrome were also significantly improved on BDI than those classified as yang syndrome. Conclusions : This study suggests that Banhahubak-tang(Banxiahoupotang) is significantly effective in patients with poststroke depression classified as yin syndrome.

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A Clinical Report of Two Patients with Poststroke Depression by Korean Traditional Treatment and Roger's Person-centered Counseling (한방치료와 Rogers의 인간중심적 상담요법으로 호전된 뇌졸중 후 우울증 치험 2례)

  • Kim, Jin-Yi;Lee, Jin-Hwan;Kim, Soo-Jung;Seo, Joo-Hee;Yoon, In-Ae;Park, Eun-Young;Sung, Woo-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.187-206
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    • 2010
  • Objectives : This study was designed to report the effect of korean traditional treatment and person-centered counseling for poststroke depression Methods : We treated two patients who scored 37 point and 32 point at Beck's depression inventory each, and 23 point and 22 point at Hamilton rating scale for depression each by korean traditional treatment and person-centered counseling, Results : After treatment, the clinical symptoms were improved and Beck's depression inventory, Hamilton rating scale for depression score were decreased, Conclusions : The result suggest that korean traditional treatment and person-centered counseling is effective in patients with poststroke depression.

Study of Efficacy and Safety of Tianwangbuxin-dan for Poststroke Depression: A Randomized, Double Blinded, Non-inferiority Trial (뇌졸중 후 우울증에 대한 천왕보심단의 유효성 및 안전성 연구 : 무작위 배정, 이중맹검, 비열등성 연구)

  • Lee, Il-Suk;Kim, Mun-Soo;Lee, Sang-Kwan
    • The Journal of Internal Korean Medicine
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    • v.35 no.2
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    • pp.145-156
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    • 2014
  • Objectives : The aim of this study was to compare Tianwangbuxin-dan to Fluoxetine for antidepressive efficacy and safety in poststroke depression (PSD). Methods : A randomized, double blinded, non-inferiority trial was conducted. 113 PSD patients were recruited from a stroke center. Except for the 25 excluded patients, 88 PSD patients were randomly given either Tianwangbuxin-dan 1100 mg or Fluoxetine 20 mg per a day for 16 weeks. PSD was evaluated using Beck's depression inventory (BDI) and Hamilton depression rating scale (HDRS) and followed every fourth week. Repeated measure analysis of variance (ANOVA) was used to compare and contrast the depression scores of the two groups and to compare them among the evaluation times, at the beginning, $4^{th}$, $8^{th}$, $12^{th}$ and $16^{th}$ weeks. In addition, independent t-tests were used to find the difference between two groups at every evaluation time. Results : Finally, 88 PSD patients were included in the study, 63 PSD patients completed the procedure and 25 PSD patients were dropped out by the incompliance or withdrawal of consent. Tianwangbuxin-dan (or Fluoxetine) improved the depression of stroke patients and the efficacy of Tianwangbuxin-dan was not inferior to that of Fluoxetine. In addition, there was no significant side effect in two groups. Conclusions : This study showed that antidepressive efficacy and safety of Tianwangbuxin-dan in PSD patients.

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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A Clinical Study of Acupuncture with Aromatherapy on Poststroke Depression Patients (중풍후우울증 환자에 대한 향기침요법의 임상적 연구)

  • Chung, Sae-Yun;Hwang, Jae-Woong;Kim, Seok-Min;Jung, Jae-Han;Choi, Chang-Min;Jung, Woo-Sang;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Sun, Jong-Joo
    • The Journal of Internal Korean Medicine
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    • v.27 no.2
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    • pp.480-487
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    • 2006
  • Objectives : In this study we investigated BDI(Beck Depression Inventory) improvement of poststroke depression Patients who took the acupuncture with aromatherapy, in order to examine its capacity as a new treatment and to establish a primary data for further studies of developments of diverse Practical acupunctures. Methods : Physicians applied the acupuncture with aromatherapy every day for two weeks. We had evaluated baseline characteristics and BDI of all Patients, and revaluated BDI and examined the side effects two weeks later. The qualified Patients were classified into two groups, depression group (more than 10 points and 10 in BDI) and non-depression group (less than 10 points in BDI) according to the baseline BDI. Results : The study was completed with 27stroke patients. The acupuncture with aroma therapy was applied in 18 post-stroke depression patients and 9 non-depression patients for 2 weeks. And the result showed that the BDI scores in the depression group decreased to $16.5{\pm}11.1$ after the treatment (compared to $24.4{\pm}11.5$ before the treatment). so proved the significant effect on post-stroke depression of the acupuncture. On the other hand. the scores in the non-depression group increased to $9.2{\pm}9.5$ (compared to $3.3{\pm}3.0$). Conclusions : The acupuncture with aromatherapy applied on post-stroke depression patients showed the effect of BDI improvement. Further researches are needed to evaluate the distinct functional mechanism of acupuncture with aromatherapy, and to estimate its effectiveness by well-designed randomized controlled trial.

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Poststroke Depression : A Review of the Latest Oriental Medicine Articles (뇌졸중 후 우울증 : 한방 치료에 대한 국내외 최신 문헌 고찰)

  • Lee, Je-Won;Lee, Bo-Mae-Na;Jang, Woo-Seok;Hwang, Ha-Yeon;Baek, Kyung-Min
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.448-464
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    • 2012
  • Objectives : This study reviews the latest articles in Korea and other countries that studied oriental medicine treatment on poststroke depression. Methods : Korean articles were retrieved from the 9 major Korean web article search engines. Foreign articles were retrieved from PubMed. Article published date was from 2000 up to September 2012. There were no restrictions on the types of publication, but articles not available in full text were excluded. The methodological quality was assessed according to Cochrane's assessment of risk of bias and Newcastle-Ottawa quality assessment scale. Results : Twenty-two articles were included in this study. Eleven articles were published in Korea, the rest were published in China. Nine articles were randomized controlled trials (RCT), one article was a non-randomized study (NRS), four articles were case reports, three articles were cross-sectional studies, two articles were comparative studies. In RCT articles, risk of selection bias and performance bias were generally high, risk of detection bias was unclear. The NRS article took four stars in Newcastle-Ottawa quality assessment. Comparison Hamilton rating scale for depression score between oriental medicine treated group and western medicine treated group revealed that there was no remarkable difference in mean score changes after treatment on PSD. Conclusions : The results of this study suggest that oriental medicine treatment is as effective as western medicine treatment for PSD. In the future, more rigorous oriental medicine treatment studies should be conducted.

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.