Neuropsychiatry of Stroke

Vani Rao, M.D.


Neuropsychiatric disorders are usually caused to stroke survivors, and the most common ones are: depression, anxiety, emotional incontinence, and catastrophic reactions. The most common one and the one that is considered to be a burden for care givers is Post Stroke Depression. PSD is usually found to hit up to 40% of the patients, which is considered a wide range and it’s important to study it since it interferes with rehabilitation, recovery and quality of life. The diagnosis of PSD is also difficult for medical professionals since some patients might have difficulty in expressing or comprehending, cognitive impairment, and there are some overlapping between symptoms of depression and medical condition of patients. The other most common one is the Post Stroke Anxiety, it occurs to up to 20% of the patients with a majority of these patients also having PSD. The worrying state of having a stroke recently, some long term injuries, and the possibility of a second stroke happening in the next five years could be present for at least six months with some symptoms like restlessness, irritability, poor energy, poor concentration, muscle tension, and poor sleep.


With the focus on the rehabilitation of the patients and trying to achieve the best outcome from it we also need to consider the mental state of the patient before and during the rehabilitation. Depression and anxiety are very common post-stroke factors as they increase morbidity and delay the recovery. Therefore, treating any neuropsychiatric post-stroke disorder can have the greatest impact on improving the quality of life post-stroke. A lot of patients might give up on life or even on recovery itself and just try to live with their disability, so showing them the potential of the treatment and convincing them that it could be a way to reach a life that is very close to the life they had pre-stroke is very important.