Schlaganfall und Psyche

Zusammenfassung

Schlaganfall und Psyche haben eine komplexe und bidirektionale Beziehung. So ist es einerseits gut bekannt, dass psychische und soziale Faktoren, „Stress“ oder auch eine Depression einen unabhängigen Risikofaktor für das Auftreten von Schlaganfällen darstellen. Umgekehrt ist es aber auch so, dass der Schlaganfall selbst zu tiefgreifenden psychischen Folgen führen kann. Insbesondere die Post-Schlaganfall-Depression spielt hier eine wichtige Rolle. Sie tritt in mindestens 1/3 aller Schlaganfall-Patienten auf und ist mit einem schlechten „Outcome“ sowie einer erhöhten Sterblichkeit assoziiert. Klinische wie experimentelle Untersuchungen aus den letzten Jahren haben zum Verständnis der vielfältigen Beziehungen zwischen Schlaganfall und Psyche beigetragen. Insbesondere die vielversprechenden Ergebnisse der FLAME-Studie, welche eine verbesserte neurologische Erholung bei der frühen Gabe von Antidepressiva bei Schlaganfall-Pa­tienten zeigte, eröffnet nun die klinische Frage, ob Schlaganfall-Patienten generell bereits zu einem frühen Zeitpunkt mit Antidepressiva behandelt werden sollten.

Abstract

The relation between mental health and stroke is complex and bidirectional. It is well established that psychosocial factors, stress and major depression constitute independent risk factors for stroke. Conversely, stroke may lead to profound psychological consequences. Post-stroke depression, in particular, plays an important role. At least one third of stroke survivors develop depression, which confers a poorer clinical outcome and increased mortality. Both clinical and experimental studies have contributed to a better understanding of the interplay between stroke and psychological factors in recent years. The promising results of the FLAME-study showed improved neurological recovery through early treatment of stroke patients with a serotonergic antidepressant. These results lead to the question, whether stroke patients in general should be treated with antidepressants at an early stage.

Schlüsselwörter

Schlaganfall - Depression - psychosozialer Stress - Post-stroke Depression

Keywords

stroke - depression - psychosocial stress - post-stroke depression

• Literatur

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