POST-STROKE PSYCHIATRIC DISORDERS: AN OVERVIEW ON ITS SCREENING AND MANAGEMENT

Authors

  • Keerthana Chandrasekar Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • Nakka Gautam Sai Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • Princy Sabu John Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • Sruthi Ninan Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • Raja D Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • Ponnusankar S Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2019.v12i1.26047

Keywords:

Post-stroke psychiatric disorder, Depression, Anxiety, Apathy, Catastrophic reactions, Mania

Abstract

Stroke is the third leading cause of death. Stroke occurs when an insufficient amount of blood is supplied to the brain due to a thrombus or an emboli leading to permanent tissue damage. Lesions in the brain can lead to psychiatric complications. The prevalence of psychiatric complications after stroke is very common. Psychiatric complications such as depression, anxiety, apathy, pseudobulbar effects (laughing and crying), mania, psychosis, and bipolar disorders are seen after stroke. In this review, various psychiatric disorders are reported among post-stroke survivors in which depression and anxiety are common. Consequently, apathy, pseudobulbar effects, catastrophic reactions, psychosis, bipolar disorder, and mania are also observed after stroke. Therefore, early detection and management of psychiatric disorders prevent further complications and improve the quality of life in post-stroke patients.

Downloads

Download data is not yet available.

Author Biographies

Keerthana Chandrasekar, Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Dept. of Pharmacy Practice

Clinical Resident

 

Nakka Gautam Sai, Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Dept. of Pharmacy Practice

Pharm D Intern

Princy Sabu John, Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Dept. of Pharmacy Practice

Pharm D Intern

Sruthi Ninan, Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Dept. of Pharmacy Practice

Pharm D Intern

Raja D, Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Dept. of Pharmacy Practice

Asst. Professor

Ponnusankar S, Department of Pharmacy Practice, JSS College of Pharmacy, Udhagamandalam, The Nilgiris, Tamil Nadu. JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.

Dept. of Pharmacy Practice

Professor & Head

References

Vani R. Neuropsychiatry of Stroke. 1st ed. Washington, DC: Psychiatry; 2015.

Robinson RG, Spalletta G. Poststroke depression: A review. Can J Psychiatry 2010;55:341-9.

Gall A. Post stroke depression. Hosp Med 2001;62:268-73.

Pierre T. Post-stroke Mania: The Behavioral and Cognitive Neurology of Stroke.1st ed. Cambridge: Cambridge University Press; 2007.

Primeau F. Post-stroke depression: A critical review of the literature. Can J Psychiatry 1988;33:757-65.

Shi Y, Xiang Y, Yang Y, Zhang N, Wang S, Ungvari GS, et al. Depression after minor stroke: Prevalence and predictors. J Psychosom Res 2015;79:143-7.

Campbell Burton CA, Holmes J, Murray J, Gillespie D, Lightbody CE, Watkins CL, et al. Interventions for treating anxiety after stroke. Cochrane Database Syst Rev 2011;12:CD008860.

Pedro L, Nuria AD. Poststroke Apathy. Rev Esp Geriatr Gerontol 2015;51:164-9.

Gupta A, Kedar M, Rajesh KR. Pathological laughter and crying. Delhi Psychiatry J 2007;10:25-30.

Santos CO, Caeiro L, Ferro JM, Figueira ML. Mania and stroke: A systematic review. Cerebrovasc Dis 2011;32:11-21.

Evans DL, Byerly MJ, Greer RA. Secondary mania: Diagnosis and treatment. J Clin Psychiatry 1995;56 Suppl 3:31-7.

Nakase T, Tobisawa M, Sasaki M, Suzuki A. Outstanding symptoms of post stroke depression during the acute phase of stroke. PLoS Med 2016;11:1-13.

McCarthy MJ, Sucharew HJ, Alwell K, Moomaw CJ, Woo D, Flaherty ML, et al. Age, subjective stress, and depression after ischemic stroke. J Behav Med 2016;39:55-64.

Jiang XG, Lin Y, Li YS. Correlative study on risk factors of depression among acute stroke patients. Eur Rev Med Pharmacol Sci 2014;18:1315-23.

Shi YZ, Xiang YT, Yang Y, Zhang N, Wang S, Ungvari GS, et al. Depression after minor stroke: Prevalence and predictors. J Psychosom Res 2015;79:143-7.

Zhang WN, Pan YH, Wang XY, Zhao Y. A prospective study of the incidence and correlated factors of post-stroke depression in China. PLoS One 2013;8:e78981.

Shi YZ, Xiang YT, Wu SL, Zhang N, Zhou J, Bai Y, et al. The relationship between frontal lobe lesions, course of post-stroke depression, and 1-year prognosis in patients with first-ever ischemic stroke. PLoS One 2014;9:e100456.

Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: A systematic review of observational studies. Stroke 2005;36:1330-40.

Loong CK, Kenneth NK, Paulin ST. Post-stroke depression: Outcome following rehabilitation. Aust N Z J Psychiatry 1995;29:609-14.

Gainotti G, Azzoni A, Razzano C, Lanzillotta M, Marra C, Gasparini F, et al. The post-stroke depression rating scale: A test specifically devised to investigate affective disorders of stroke patients. J Clin Exp Neuropsychol 1997;19:340-56.

Metoki N, Sugawara N, Hagii J, Saito S, Shiroto H, Tomita T, et al. Relationship between the lesion location of acute ischemic stroke and early depressive symptoms in Japanese patients. Ann Gen Psychiatry 2016;15:12.

Wolfe CD, Crichton SL, Heuschmann PU, McKevitt CJ, Toschke AM, Grieve AP, et al. Estimates of outcomes up to ten years after stroke: Analysis from the prospective south London stroke register. PLoS Med 2011;8:e1001033.

Gawronski DW, Reding MJ. Post-stroke depression: An update. Curr Atheroscler Rep 2001;3:307-12.

Youn JI, Sung KK, Song BK, Kim M, Lee S. Effects of electro-acupuncture therapy on post-stroke depression in patients with different degrees of motor function impairments: A pilot study. J Phys Ther Sci 2013;25:725-8.

Alexopoulos GS, Wilkins VM, Marino P, Kanellopoulos D, Reding M, Sirey JA, et al. Ecosystem focused therapy in poststroke depression: A preliminary study. Int J Geriatr Psychiatry 2012;27:1053-60.

Parke HL, Epiphaniou E, Pearce G, Taylor SJ, Sheikh A, Griffiths CJ, et al. Self-management support interventions for stroke survivors: A Systematic meta-review. PLoS One 2015;10:e0131448.

Pustokhanova L, Morozova E. Cognitive impairment and hypothymia in post stroke patients. J Neurol Sci 2013;325:43-5.

López-Liria R, Vega-Ramírez FA, Rocamora-Pérez P, Aguilar-Parra JM, Padilla-Góngora D. Comparison of two post-stroke rehabilitation programs: A Follow-up study among primary versus specialized health care. PLoS One 2016;11:e0166242.

Lennon O, Blake C. Cardiac rehabilitation adapted to transient ischaemic attack and stroke (CRAFTS): A randomised controlled trial. BMC Neurol 2009;9:9.

Wichowicz HM, Puchalska L, Rybak-Korneluk AM, Gąsecki D, Wiśniewska A. Application of solution-focused brief therapy (SFBT) in individuals after stroke. Brain Inj 2017;31:1507-12.

Andersen G, Vestergaard K, Lauritzen L. Effective treatment of poststroke depression with the selective serotonin reuptake inhibitor citalopram. Stroke 1994;25:1099-104.

Jakobsen JC, Lindschou Hansen J, Storebø OJ, Simonsen E, Gluud C. The effects of cognitive therapy versus treatment as usual†in patients with major depressive disorder. PLoS One 2011;6:e22890.

Thomas SA, Coates E, das Nair R, Lincoln NB, Cooper C, Palmer R, et al. Behavioural activation therapy for depression after stroke (BEADS): A study protocol for a feasibility randomised controlled pilot trial of a psychological intervention for post-stroke depression. Pilot Feasibility Stud 2016;2:45.

Mitchell PH, Veith RC, Becker KJ, Buzaitis A, Cain KC, Fruin M, et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: Living well with stroke: Randomized, controlled trial. Stroke 2009;40:3073-8.

Kootker JA, Fasotti L, Rasquin SM, van Heugten CM, Geurts ACh. The effectiveness of an augmented cognitive behavioural intervention for post-stroke depression with or without anxiety (PSDA): The restore4Stroke-PSDA trial. BMC Neurol 2012;12:51.

Alexopoulos GS, Raue PJ, Kiosses DN, Mackin RS, Kanellopoulos D, McCulloch C, et al. Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction: Effect on disability. Arch Gen Psychiatry 2011;68:33-41.

Robinson RG, Jorge RE, Long J. Prevention of poststroke mortality using problem-solving therapy or escitalopram. Am J Geriatr Psychiatry 2017;25:512-9.

Barker-Collo S, Krishnamurthi R, Witt E, Feigin V, Jones A, McPherson K, et al. Improving adherence to secondary stroke prevention strategies through motivational interviewing: Randomized controlled trial. Stroke 2015;46:3451-8.

Eum Y, Yim J. Literature and art therapy in post-stroke psychological disorders. Tohoku J Exp Med 2015;235:17-23.

Kim DS, Park YG, Choi JH, Im SH, Jung KJ, Cha YA, et al. Effects of music therapy on mood in stroke patients. Yonsei Med J 2011;52:977-81.

Altenmuller EO, Schlaug G. Neurologic music therapy: The beneficial effects of music making on neurorehabilitation. Acoust Sci Technol 2013;34:5-12.

Forsblom A, Laitinen S, Särkämö T, Tervaniemi M. Therapeutic role of music listening in stroke rehabilitation. Ann N Y Acad Sci 2009;1169:426-30.

Jessica L, Arpan S, Donglin Y, Jessica R. Acute stroke, effect on mood, and music therapy: A non-pharmacological intervention. J Neurol 2017;88 Suppl 16:288.

Amengual JL, Rojo N, Veciana de Las Heras M, Marco-Pallarés J, Grau-Sánchez J, Schneider S, et al. Sensorimotor plasticity after music-supported therapy in chronic stroke patients revealed by transcranial magnetic stimulation. PLoS One 2013;8:e61883.

Schneider S, Schönle PW, Altenmüller E, Münte TF. Using musical instruments to improve motor skill recovery following a stroke. J Neurol 2007;254:1339-46.

Beesley K, White JH, Alston MK, Sweetapple AL, Pollack M. Art after stroke: The qualitative experience of community dwelling stroke survivors in a group art programme. Disabil Rehabil 2011;33:2346-55.

Obembe A, Mapayi B, Johnson O, Agunbiade T, Pt BM, Emechete A. Community reintegration in stroke survivors: Relationship with motor function and depression. Hong Kong Physiother J 2013;31:69-74.

Block VA, Pitsch E, Tahir P, Cree BA, Allen DD, Gelfand JM, et al. Remote physical activity monitoring in neurological disease: A Systematic review. PLoS One 2016;11:e0154335.

Flöel A, Werner C, Grittner U, Hesse S, Jöbges M, Knauss J, et al. Physical fitness training in subacute stroke (PHYS-STROKE) – study protocol for a randomised controlled trial. Trials 2014;15:45.

Bonner NS, O’Halloran PD, Bernhardt J, Cumming TB. Developing the stroke exercise preference inventory (SEPI). PLoS One 2016;11:e0164120.

Barak S, Hutzler Y, Dubnov-Razi G. Physical exercise after stroke: Effects, recommendations and barriers. Harefuah 2016;155:378- 83, 384.

Plow M, Moore SM, Kirwan JP, Frost F, Katzan I, Jaeger S, et al. Randomized controlled pilot study of a systemCHANGEâ„¢ weight management intervention in stroke survivors: Rationale and protocol. Trials 2013;14:130.

Prathikanti S, Rivera R, Cochran A, Tungol JG, Fayazmanesh N, Weinmann E, et al. Treating major depression with yoga: A prospective, randomized, controlled pilot trial. PLoS One 2017;12:e0173869.

Chan W, Immink MA, Hillier S. Yoga and exercise for symptoms of depression and anxiety in people with poststroke disability: A randomized, controlled pilot trial. Altern Ther Health Med 2012;18:34-43.

Kawakita K, Okada K. Acupuncture therapy: Mechanism of action, efficacy, and safety: A potential intervention for psychogenic disorders? Biopsychosoc Med 2014;8:4.

Man SC, Hung BH, Ng RM, Yu XC, Cheung H, Fung MP, et al. A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression. BMC Complement Altern Med 2014;14:255.

Zhang GC, Fu WB, Xu NG, Liu JH, Zhu XP, Liang ZH, et al. Meta analysis of the curative effect of acupuncture on post-stroke depression. J Tradit Chin Med 2012;32:6-11.

Menghan L, Bo Z, Zhihong M, Tao S, Yuhui H, Hong Z, et al. Effect of Tiao shen Kai qiao acupuncture in the treatment of ischemic post-stroke depression: A randomized controlled trial. J Tradit Chin Med 2017;37:171-8.

Harmandayan M, Romanowicz M, Sola C. Successful use of ECT in post-stroke depression. Gen Hosp Psychiatry 2012;34:102.e5-6.

Shen X, Liu M, Cheng Y, Jia C, Pan X, Gou Q, et al. Repetitive transcranial magnetic stimulation for the treatment of post-stroke depression: A systematic review and meta-analysis of randomized controlled clinical trials. J Affect Disord 2017;211:65-74.

Brunoni AR, Boggio PS, De Raedt R, Benseñor IM, Lotufo PA, Namur V, et al. Cognitive control therapy and transcranial direct current stimulation for depression: A randomized, double-blinded, controlled trial. J Affect Disord 2014;162:43-9.

Gu SY, Chang MC. The effects of 10-hz repetitive transcranial magnetic stimulation on depression in chronic stroke patients. Brain Stimul 2017;10:270-4.

Wright F, Wu S, Chun HY, Mead G. Factors associated with post stroke anxiety: A systematic review and meta-analysis. Stroke Res Treat 2017;2017:1-7.

Masskulpan P, Riewthong K, Dajpratham P, Kuptniratsaikul V. Anxiety and depressive symptoms after stroke in 9 rehabilitation centers. J Med Assoc Thai 2008;91:1595-602.

Barker-Collo SL. Depression and anxiety 3 months post stroke: Prevalence and correlates. Arch Clin Neuropsychol 2007;22:519-31.

Mok E, Woo CP. The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients. Complement Ther Nurs Midwifery 2004;10:209-16.

Golding K, Kneebone I, Fife-Schaw C. Self-help relaxation for post-stroke anxiety: A randomised, controlled pilot study. Clin Rehabil 2016;30:174-80.

Brown RP, Gerbarg PL. Sudarshan kriya yogic breathing in the treatment of stress, anxiety, and depression. Part II – Clinical applications and guidelines. J Altern Complement Med 2005;11:711-7.

Caeiro L, Ferro JM, Costa J. Apathy secondary to stroke: A systematic review and meta-analysis. Cerebrovasc Dis 2013;35:23-39.

van Dalen JW, Moll van Charante EP, Nederkoorn PJ, van Gool WA, Richard E. Poststroke apathy. Stroke 2013;44:851-60.

Petrova EA, Ponevezhskaia EV, Savina MA, Skvortsova VI. Clinical features of post stroke apathy. Zh Nevrol Psikhiatr Im S S Korsakova 2012;112:15-9.

Tang WK, Caeiro L, Lau CG, Liang H, Mok V, Ungvari GS, et al. Apathy and suicide-related ideation 3 months after stroke: A cross-sectional study. BMC Neurol 2015;15:60.

Bingelien A, Shapiro CM, Sockalingam S, Hawa RJ. Pathological laughing and crying post-stroke. Liaison Psychiatrist Beware 2016;6:15-21.

Rajdeep R, Andrew H. Post-stroke mania: A rare but treatable presentation. Prog Neurol Psychiatry 2014;18:24-5.

Chemerinski E, Robinson RG. The neuropsychiatry of stroke. Psychosomatics 2000;41:5-14.

Teasell R. Catastrophic reaction after stroke. A case study. Am J Phys Med Rehabil 1993;72:151-3.

Mnif L, Sellami R, Masmoudi J. Post-stroke emotional incontinence or bipolar disorder? Neuropsychiatr Dis Treat 2016;12:1883-5.

Berthier ML, Kulisevsky J, Gironell A, Fernández Benitez JA. Poststroke bipolar affective disorder: Clinical subtypes, concurrent movement disorders, and anatomical correlates. J Neuropsychiatry Clin Neurosci 1996;8:160-7.

Vasudev A, Thomas A. Bipolar disorder†in the elderly: What’s in a name? Maturitas 2010;66:231-5.

Srivastava S, Agarwal MP, Gautam A. Post stroke psychosis following lesions in basal ganglion. J Clin Diagn Res 2017;11:VD01-2.

McMurtray A, Tseng B, Diaz N, Chung J, Mehta B, Saito E, et al. Acute psychosis associated with subcortical stroke: Comparison n basal ganglia and mid-brain lesions. Case Rep Neurol Med 2014;2014:428425.

Bielawski M, Bondurant H. Psychosis following a stroke to the cerebellum and midbrain: A case report. Cerebellum Ataxias 2015;2:17.

Vurumadla S, Rakshith V, Murari C, Venkateshwarlu K. A study on symptoms, risk factors and prescribing pattern of drugs used in stroke patients. Int J Pharm Pharm Sci 2014;7:421-6.

Spurthi T, Rani KR, Navya Y, Swathi D, Kumar PR. Acute post complications in stroke patients visiting a tertiary teaching hospital. Int J Pharm Pharm 2018;10:95-7.

Published

07-01-2019

How to Cite

Chandrasekar, K., N. G. Sai, P. S. John, S. Ninan, R. D, and P. S. “POST-STROKE PSYCHIATRIC DISORDERS: AN OVERVIEW ON ITS SCREENING AND MANAGEMENT”. Asian Journal of Pharmaceutical and Clinical Research, vol. 12, no. 1, Jan. 2019, pp. 11-15, doi:10.22159/ajpcr.2019.v12i1.26047.

Issue

Section

Review Article(s)

Most read articles by the same author(s)