• 생물정신의학
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• 제12권2호
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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.

• 대한한방내과학회지
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• 제26권3호
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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.

• 생물정신의학
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• 제19권4호
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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.

• 대한한방내과학회지
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• 제26권3호
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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.

• 동의신경정신과학회지
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• 제21권4호
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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.

• 대한한방내과학회지
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• 제35권2호
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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.

• 정신신체의학
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• 제6권1호
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• pp.79-84
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• 1998

저자들은 뇌졸중후 우울증보다 매우 드물게 발생하는 뇌졸중후 양극성장애 증례를 경험하여 보고하였다. 좌반구 기저핵 뇌경색이후 뇌졸중후 우울증을 앓아오던 환자에서 조증 에피소드가 발병하여 원인을 규명하는 과정에서 자기공명영상을 시행한 결과, 이차성 양극 성장애와 연관되는 것으로 보고되어온 우반구 기저핵의 새로운 뇌경색이 밝혀졌다. 한 환자에서 좌반구 뇌졸중이후 우울증, 우반구 뇌졸중이후 양극성장애의 발생이 시간적 연관성을 보였으며, 한편 뇌졸중후 우울증과 이차성 양극성장애 각각이 병변 위치와 특이한 연관성을 보여주고 있다. 문헌 고찰에 의하면, 이차성 조증이 주로 피질의 병변과 연관성을 보이는 반면, 양극성 장애는 피질하 병변에서 호발하는 것으로 보고되어왔으며, 이차성 조종의 위험인자로는 정신장애의 가족력과 경한 피질하 위축이 제시되었다. 이 증례에서도 우반구 피질하 병변과 경한 피질하 위축이 관찰되었다. 뇌졸중 병변위치와 기분장애의 상관성 및 위험인자에 대한 연구는, 일차성 기분장애의 신경생물학적 연구에 기여할 수 있을 것이며, 임상에서도 뇌졸중 환자의 정신증상 치료에서 조중 유발의 위험성을 인식하는데 도움이 될수 있을 것이다.

• 대한한방내과학회지
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• 제27권2호
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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.

• 대한한방내과학회지
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• 제33권4호
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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.

• 대한물리의학회지
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• 제5권4호
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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.