RESEARCH PAPER
Neuropsychological rehabilitation of patients with symptoms of depression after ischemic stroke
Dorota Mroczkowska 1, 2  
,   Emilia Bałdyga 2  
,   Tadeusz Żechowicz 2, 3  
,   Leszek Gromadziński 2, 3  
 
More details
Hide details
1
Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
2
Clinical University Hospital, Olsztyn, Poland
3
Department of Cardiology and Cardiac Surgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
CORRESPONDING AUTHOR
Dorota Mroczkowska   

Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +48 531 052 830.
Submission date: 2018-11-13
Final revision date: 2018-12-03
Acceptance date: 2018-12-03
Online publication date: 2019-12-12
 
Pol. Ann. Med. 2019;26(2):130–133
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Depression significantly affects the effects of rehabilitation, quality of life, as well as patients’ mortality. The estimated prevalence of post-stroke depression is approximately 25%–70%.

Aim:
To examine when neuropsychological rehabilitation after stroke affects the cognitive functions of people suffering from depression.

Material and methods:
42 persons after ischemic stroke suffering from depression took part in the study. The participants were in 3 weeks daily neurological rehabilitation care. Mood disorders were measured by Beck depression inventory. Cognitive functions were examined using verbal fluency test and following psychological tests: mini mental state examination, color trail test and Benton visual retention test.

Results and discussion:
Mood disorders were diagnosed in 70% of patients. The neuropsychological diagnosis revealed existing memory disorders, low resistance to distractors (30.9% participants), impaired visuospatial function (78.7%), impaired ability to recognize visual stimuli with preserved normal vision, weakened executive functions, in particular planning, initiating and sustaining activities (85.6%), rigid thinking, slackening, difficulty with focusing on the task, problems with selective attention and increased levels of anxiety. Verbal fluency deficits was diagnosed in 92.9% of patients. Significant improvements were observed for all cognitive domains after neuropsychological rehabilitation. The biggest improvement was noted in the attentional domain (73.8%), the least – in the visuo-spatial functions (21.4%).

Conclusions:
Depression is a frequent and important problem among patients with stroke, as a post-stroke depression is present in at least 30% of survivors from stroke. Psychological complications such as emotional, behavioral and cognitive disorders, can have a negative effects on the social functioning and the overall quality of life of stroke survivors.

CONFLICT OF INTEREST
None.
FUNDING
None.
 
REFERENCES (23)
1.
Sienkiewicz-Jarosz H, Milewska D, Bochyńska A, et al. Predictors of depressive symptoms in patients with stroke – a three-month follow-up. Neurol Neurochir Pol. 2010;44(4):13–20. https://doi.org/10.1016/S0028-....
 
2.
Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry. 2003;54,(3):376–387.
 
3.
Ryglewicz D. [Ischemic stroke epidemiology]. Medycyna. 2000;27/28:38–40 [in Polish].
 
4.
Lenzi GL, Altieri M, Maestrini I. Post-stroke depression. Rev Neurol. 2008;164(10):837–840. https://doi.org/10.1016/j.neur....
 
5.
Zavoreo I, Basic-Kes V, Bosnar-Puretic M, Demarin V. Post-stroke depression. Acta Clin Croat. 2009;48(3):329–333.
 
6.
Abaraogu UO, Opara MC. Depression and dynamic balance recovery among stroke survivors: A preliminary investigation. Pol Ann Med. 2017;24(2):123–128. http://dx.doi.org/10.1016/j.po....
 
7.
Bejer A, Probachta M, Sochacki A. [Fatigue after stroke – clinical and demographic correlates]. Prz Med Uniw Rzesz Inst Leków. 2010;3:298–304 [in Polish].
 
8.
Katon W, Sullivan MD. Depression and chronic medical illness. Clin Psychiatry. 1990;51 Suppl:3–11.
 
9.
Jaracz J, Rybakowski J. Frontal syndrome in schizophrenia and frontotemporal dementia: diagnostic and therapeutic implications. Neuropsychiatry Neuropsychol. 2011;6(1):18–24 [in Polish].
 
10.
Dam H. Depression in stroke patients 7 years following stroke. Acta Psychiatr Scand. 2001;103:287–293. https://doi.org/10.1034/j.1600....
 
11.
Głodzik-Sobańska L, Słowik A, Borratyńska A, Szczudlik A. [Depressive symptoms following ischemic stroke]. Neurol Neurochir Pol. 2003;37(1): 17–25 [in Polish].
 
12.
Bilikiewicz A. [Psychiatry. The handbook for medical students]. Warszawa: PZWL. 2011 [in Polish].
 
13.
Jodzio K. [Neuropsychological diagnostic in clinical practise].Warszawa: Difin. 2011 [in Polish].
 
14.
Cumming TB, Churilov L, Skoog I, Blomstrand C, Linden T. Little evidence for different phenomenology in poststroke depression. Acta Psychiatr Scand. 2010;121(6):424–430. https://doi.org/10.1111/j.1600....
 
15.
da Rocha e Silva CE, Alves Brasil MA, Matos do Nascimento E, de Bragança Pereira B, André C. Is poststroke depression a major depression? Cerebrovasc Dis. 2013;35(4):385–391. https://doi.org/10.1159/000348....
 
16.
Nishiyama Y, Komaba Y, Ueda M, Nagayama H, Amemiya S, Katayama Y. Early depressive symptoms after ischemic stroke are associated with a left lenticulocapsular area lesion. J Stroke Cerebrovasc Dis. 2010;19(3):184–189. https://doi.org/10.1016/j.jstr....
 
17.
Caeiro L,  Ferro JM,  Santos CO, Figueira ML. Depression in acute stroke. J Psychiatry Neurosci. 2006;31(6):377–383.
 
18.
Seniów J, Mazurkiewicz P. [Stroke focal cognitive-behavioral syndromes and simple clinical tasks for detecting]. Neurol Dypl. 2012;7(6):41–46 [in Polish].
 
19.
Prigatano GP. [Neuropsychological rehabilitation]. Warszawa: PWN. 2009 [in Polish].
 
20.
Bilikiewicz A, Matkowska-Białko D. [Cognitive impairment and depression]. Udar Mózgu. 2004;6(1):27–37 [in Polish].
 
21.
Mossakowska M, Więcek A, Błędowski P. [Medical, psychological, sociological and economic aspects of the aging of people in Poland]. Poznań: Termedia. 2012 [in Polish].
 
22.
Caeiro L, Ferro JM, Santos CO, Figueira ML. Depression in acute stroke. J Psychiatry Neurosci. 2006;31(6):377–383.
 
23.
Wiszniewska M, Kobayashi A, Członkowska A. [Management in stroke]. Pol Prz Neurol. 2012;8(4):161–175 [in Polish].