Abstract
Depression is a common neuropsychiatric consequence of stroke. Apathy is also often observed after stroke and is defined as reduced motivation or lack of initiative and motivation, and used commonly in the neurological field. However, in psychological field, apathy (loss of interest) is thought to be a partial symptom of depression. In this way, depression and apathy has been confused from department to department. Previously we examined neuroanatomical finding as concerned with the depressive and apathetic dimensions of post-stroke depression (PSD) separately, demonstrated that the severity of depression (SDS score) was associated with left frontal lobe (but not basal ganglia) damage, and that of apathy (AS score) was related to damage to the bilateral basal ganglia (but not to the frontal lobe) . We also examined the effect of depression and apathy on the functional recovery after stroke, suggested that the apathy was a predictor of poor functional recovery after stroke. Thus it is thought that after a stroke there are two separate core symptoms (“ depressed mood ” or “ loss of interest ”) with different underlying neuroanatomical mechanisms. After stroke, emotional response is also important factor for understanding the mechanisms of the post-stroke depression. Insistence on recovery is thought to be a sign of denial and thus is regarded as an irrational belief. However, our previous study demonstrated that the appropriate level of insistence on recovery reduced depression and apathy, resulting in enhanced improvement of disability after a stroke. When caring for patients, we should inform them of their prognosis in such a way that they do not give up hope.
