[Post-stroke depression (I). Epidemiology, diagnostic criteria and risk factors].

AIM: Post-stroke depression (PSD) is the most frequent neuropsychiatric condition after a stroke. We review the diagnostic criteria, differential diagnosis, type of scales applied, the epidemiological studies and associated risk factors in PSD. DEVELOPMENT: PSD may be considered early when appear in the first three months after a stroke or late. We reviewed PSD case series, Stroke Unit or rehabilitation Unit studies, and community studies. Frequency of PSD has been estimated between 18 and 60%. Several methodological problems regarding inclusion criteria (acute vs chronic patients, exclusion of demented and aphasic patients), type of scales used (self applied scales, DSM-IV criteria interview, Hamilton, etc.) limit direct comparison between studies. Symptoms of PSD appear in three areas: cognition, affective and somatic. Relation between stroke location in left frontal region and left basal ganglia has not been demonstrated in further epidemiological studies.
CONCLUSION: Post-stroke depression is a highly prevalent, potentially treatable and infra-diagnosed condition. Disparity in inclusion criteria, study timing and types of scales are the main bias of the PSD epidemiological studies.