Background: Data on post-stroke depression in aphasia are scarce. Methods: Eighty-nine acute stroke patients with aphasia of all types were followed for 6 months to investigate if depression can be reliably diagnosed (DSM-IV criteria) and validly assessed by the verbal Montgomery-Åsberg Depression Rating Scale (MADRS) and a global technique (Clinical Global Impressions Rating Scale for Severity). A standard aphasia test was performed. Results: In 60 patients (67%) at baseline and in 100% at 6 months, comprehension allowed a reliable DSM-IV diagnosis. Among these patients MADRS was feasible in 95% at baseline and in 100% at 6 months. The assistance of relatives and staff increases the feasibility and decreases the validity. Depression was identified in 24% during the 6 months. Conclusion: Depression diagnosis and severity rating can reliably be made in the acute phase in at least two thirds of aphasic patients, and feasibility increases over time.

1.
Hackett ML, Yapa C, Parag V, Anderson CS: Frequency of depression after stroke: a systematic review of observational studies. Stroke 2005;36:1330–1340.
2.
Starkstein S, Robinson RG: Aphasia and depression. Aphasiology 1988;2:1–20.
3.
Turner-Stokes L: Poststroke depression: getting the full picture. Lancet 2003;361:1757–1758.
4.
Astrom M, Adolfsson R, Asplund K: Major depression in stroke patients: a 3-year longitudinal study. Stroke 1993;24:976–982.
5.
Kauhanen M, Korpelainen JT, Hiltunen P, Brusin E, Mononen H, Maatta R, Nieminen P, Sotaniemi KA, Myllyla VV: Poststroke depression correlates with cognitive impairment and neurological deficits. Stroke 1999;30:1875–1880.
6.
Hackett ML, Andersson CS, House A: Management of depression after stroke: a systematic review of pharmacological therapies. Stroke 2005;36:1092–1097.
7.
Leeds L, Meara RJ, Hobson JP: The utility of the Stroke Aphasia Depression Questionnaire (SADQ) in a stroke rehabilitation unit. Clin Rehabil 2004;18:228–231.
8.
Benaim C, Cailly B, Perennou D, Pelissier J: Validation of the aphasic depression rating scale. Stroke 2004;35:1692–1696.
9.
Laska AC, von Arbin M, Kahan T, Hellblom A, Murray V: Long-term antidepressant treatment with moclobemide for aphasia in acute stroke patients: a randomised, double-blind, placebo-controlled study. Cerebrovasc Dis 2005;19:125–132.
10.
Blomert L, Kean M-L, Koster C, Schokker J: Amsterdam-Nijmegen-Everyday-Language-Test: construction, reliability and validity. Aphasiology 1994;8:381–407.
11.
Laska AC, Hellblom A, Murray V, Kahan T, von Arbin M: Aphasia in acute stroke and relation to outcome. J Intern Med 2001;249:413–422.
12.
Röden-Jüllig Å, Britton M, Gustavsson C, Fugl-Meyer A: Validation of four scales for acute stage of stroke. J Intern Med 1994;236:125–136.
13.
Mahoney FI, Barthel DW: Functional evaluation: Barthel Index. Md State Med J 1965;14:61–65.
14.
Reinvang I: Aphasia and Brain Organisation. New York, Plenum Press, 1985.
15.
Kertesz A: Western Aphasia Battery. New York, Grune & Stratton, 1982.
16.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
17.
Montgomery SA, Åsberg M: A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382–389.
18.
Murray V, von Arbin M, Bartfai A, Berggren A-L, Landtblom A-M, Lundmark J, Näsman P, Olsson J-E, Samuelsson M, Tereént A, Varelius R, Åsberg M, Mårtensson B: Double-blind comparison of sertraline and placebo in stroke patients with minor depression and less severe major depression. J Clin Psychiatry 2005;66:708–716.
19.
Guy W: Clinical global impression; in Early Clinical Drug Evaluation Unit (ECDEU). Rockville, National Institute of Health, 1976, pp 218–222.
20.
Deeks JJ, Altman DG: Diagnostic tests 4: likelihood ratios. Br Med J 2004;329:168–169.
21.
Damecour C, Caplan D: The relationship of depression to symptomatology and lesion site in aphasic patients. Cortex 1991;27:385–401.
22.
Sutcliffe L, Lincoln NB: The assessment of depression in aphasic stroke patients: the development of the Stroke Aphasic Depression Questionnaire. Clin Rehabil 1998;12:506–513.
23.
Carota A, Berney A, Aybek S, Iaria G, Staub F, Ghika-Schmid F, Annable L, Guex P, Bogousslavsky J: A prospective study of predictors of poststroke depression. Neurology 2005;64:428–433.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.