Psychiatric Disorders Following Stroke

－Depression and apathy－

Abstract

The number of stroke patients in Japan continues to increase because of decreasing mortality and progress of aging. Depression and apathy after stroke occur frequently and have a significant influence on quality of life in stroke patients. Pathophysiological mechanisms lesion locations which cause psychiatric disorders are important issues still being debated. The antidepressant treatment of post-stroke depression (PSD) has been shown to improve activities of daily living, cognitive function and survival rate. Thus, appropriate diagnosis and treatment of PSD are very important. Apathy without depressed mood means true apathy, in which case, it is more effective than dopamine agonists in comparison to antidepressants such as SSRI. Patients with depression need rest, in contrast to patients with non-depressed apathy who need activity behavioral therapy. In the future, it is very important for post-stroke patients to be managed by a medical team and to establish a community network providing them with care and support.