Challenges of making diagnoses in clinical practice

Making an accurate diagnosis of post-stroke neuropsychiatric symptoms, including depression can be challenging, partly because of the overlap in symptoms and partly because the symptoms of stroke can mask some neuropsychiatric symptoms.^1,4 A further complication comes from the possibility that psychological disturbances could pre-date the stroke; this can have an impact on the course of a stroke and the recovery period, highlighting the importance of diagnosis and clinical management of post-stroke neuropsychiatric symptoms.⁴

References:
1.Zhang S, Xu M, Liu ZJ, Feng J, Ma Y. Neuropsychiatric issues after stroke: clinical significance and therapeutic implications. World J Psychiatry 2020; 10 (6): 125–138.

2.Baker C, Worrall L, Rose M, Ryan B. Stroke health professionals’ management of depression after post-stroke aphasia: a qualitative study. Disabil Rehabil 2021; 43 (2): 217–228.

3.Sachdev PS. Post-stroke cognitive impairment, depression and apathy: untangling the relationship. Am J Geriatr Psychiatry 2018; 26 (3): 301–303.

4.UK and Ireland National Clinical Guideline for Stroke. Rehabilitation and recovery – psychological effects of stroke. Available at: https://www.strokeguideline.org/chapter/psychological-effects-of-stroke/#385. Accessed May 2023.