U. LEEDS (UK)—Depression after stroke is not uncommon, but is expected to be short-lived. When it lasts for several months and becomes severe, physical recovery is affected as well.

A study of more than 400 stroke survivors revealed that one year after a stroke, patients with prolonged depression were more likely to have problems with speech and movement and were still struggling with simple tasks such as walking upstairs or holding a conversation.

The psychological wellbeing of stroke survivors is seldom monitored, researchers say.

Patients are given antidepressants but those who would benefit from extra help to combat depression, in addition to prescribed drugs, are not identified.

“There are all sorts of reasons why stroke survivors who succumb to depression do worse,” says Kate Hill of the University of Leeds, who led the study. “They may not be engaging in their rehab, they may not be taking their medication, and they may become more socially isolated.

“The label of post-stroke depression is extremely common, especially in elderly care wards. Our results suggest that a policy of ‘watch and wait’ would be better rather than automatically giving out anti-depressants.”

Some patients that experience depression improve relatively quickly, while some still suffer considerable psychological distress after six months.

“Some patients’ mood will improve after a short time but others will remain depressed for several months. We need a longer term view of looking at psychological effects after stroke,” Hill says.

The study is published online in the journal Stroke.

The researchers also found that patients with persistent depression after a stroke were most likely to have had psychological health problems in the past.

“If we can understand how people are likely to react after a stroke, for instance by looking at how they responded to previous psychological health problems, we can perhaps find better ways of managing the associated depression,” Hill says.

The Stroke Association and the NHS Service Delivery and Organisation Research and Development programme

“Because a stroke happens in the brain, it can result in many different effects,” says Sharlin Ahmed, Research Liaison Officer at The Stroke Association.

“Most people recognise the physical symptoms, but often the psychological changes are ignored. Greater understanding about the links between depression and stroke will help medical professionals to better manage the condition.”

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