How about treating post-stroke depression?

  Cerebrovascular disease, after malignant neoplasm and cardiovascular disease, is the third most deadly disease in western industrialized countries. At present, doctors mainly use neurological signs such as recovery of limb strength as an indicator to determine the diagnosis and treatment of the disease, but often ignore the impact of the disease on patients’ psycho-social function. Post-stroke depression is a common complication of stroke, with “an incidence of 60.3% among stroke patients in China, which seriously affects patients’ motivation and initiative in rehabilitation” and “affects patients’ recovery of physical and verbal functions, improvement of cognitive function, quality of life, and may prolong hospitalization and improve the quality of life. It “affects the recovery of physical and speech functions, the improvement of cognitive function, the improvement of quality of life, and prolongs hospitalization and increases the mortality rate of patients”. Therefore, there is an urgent need to establish a systematic and effective program for the treatment of post-stroke depression and to treat patients in a holistic manner so that they can recover better.  Because stroke is an organic disease, it can damage the emotional center or conduction pathways, resulting in a decrease of biochemical transmitters in the brain, especially norepinephrine and 5-hydroxytryptamine, leading to depression. Studies have shown a significant positive correlation between neurological deficits and the degree of depression in post-stroke depressed patients, with neurological deficits promoting the development of depressive states. Conversely, depressive states have a negative effect on neurological deficits and recovery of daily living skills. Therefore, it is important to understand the location and severity of the disease as the beginning of a comprehensive understanding of the function of the organism in stroke patients. At the same time, if conditions permit, the patient’s blood and cerebrospinal fluid norepinephrine and 5-hydroxytryptamine levels can be monitored. Those who meet the diagnostic criteria for depression according to the Chinese psychiatric diagnostic criteria should be treated with antidepressants. At present, the main drugs with good efficacy and less side effects are fluoxetine and sertraline hydrochloride.  2, care about the patient’s psychological changes, timely understanding of the patient’s psychological state Once again we need to recognize that for newly admitted patients, living in an unfamiliar hospital, coupled with the fear of disease and depression, it is necessary to lift the patient’s adverse emotional interference in the first time, so that they are in the best state to receive treatment, using diversionary language and neurology professional theoretical knowledge to guide patients, recognize that stroke is a curable Through the efforts of health care professionals and themselves, they can recover and return to society.  The influence of family and social support on the physical and mental health of patients is being increasingly appreciated. Patients are very much in need of family companionship and visits from friends and relatives after illness, so patients’ relatives and friends are encouraged to visit often to give comfort, encouragement and support to patients, so that they can fully enjoy the warmth from family and society. Family members select acupuncture points and massage methods, follow the law of hemiplegia recovery, carry out rehabilitation functional training regularly every day in a step-by-step manner, and provide individual guidance to patients with limb disorders.  In fact, the communication between patients can also be positive social support. Patients who cooperate closely with treatment and have obvious rehabilitation effects are invited to introduce successful experiences, and patients who suffer from complications are also invited to talk about lessons learned.  4. Use psychological scales to understand patients’ quality of life and emotions. As a “living” organism, patients’ neurological and social functions are changing, which can be prevented if a dynamic balance is maintained. The quality of survival of depressed patients after stroke is currently evaluated internationally using the Medical Outcome Study Short Form. The Hamilton Depression Inventory and the Hutchinson Depression Self-Rating Inventory can also be used.  The best recovery is possible if the above points are achieved and “medication is combined with psychotherapy and social supportive psychotherapy to help patients understand and treat their illness correctly and cooperate with treatment actively by listening, explaining, guiding, encouraging and comforting”.