Post Stroke Depression Literature Review

EMERGING NON PHARMACOLOGICAL THERAPY FOR POST STROKE DEPRESSION AND ITS FUTURE ASPECTS: A REVIEW
ABSTRACT
Background: Post stroke depression (PSD) is a psychiatric disorder associated with stroke which has an adverse effect on the cognitive function and survival. It usually develops in 40% of the stroke survivors within 3 months. This article reviews the research examining on non pharmacological treatment for PSD.
Methods: A thorough literature review was performed using PsychInfo, PubMed, ScienceDirect, and PLOS databases for non pharmacological treatment of PSD.
Results: Early rehabilitation and psychological therapies are effective in treating depression in PSD while physiotherapy and music therapy are known to improve both cognitive and

PsychInfo, PubMed, ScienceDirect, and PLOS databases, for articles in English were reviewed using search words of post stroke depression, non pharmacological treatment, cognitive impairment, quality of life, rehabilitation and caregiver. Similar interventions were collected, compared and examined accurately. The review is aimed at summarizing the solid evidence of non pharmacological treatment used to treat post stroke depression.
Fig.1. Non pharmacological treatment options to treat PSD

3. RESULTS
EMERGING NON PHARMACOLOGICAL TREATMENT FOR POST STROKE DEPRESSION
3.1. SELF MANAGEMENT
Self management is defined as the function that a patient must be engaged in order to survive the chronic condition. The core components of self management are medical and emotional management. The main goals of self management are:

· Manage emotional consequences after stroke
· Manage medical task (prevention of secondary stroke)
· Maintain behaviour or life roles (back to work)
· Deal with the psychological consequences of the

Stroke survivors must engage in aerobic training 3-5 days a week. During acute phase, light exertion and during advanced phases, exercise at higher intensity is required. Social support and physical training consultation are required to encourage stroke survivors to conduct physical exercise (Barak et al., 2016). Physical activities can be monitored by medical devices such as accelerometer, pedometer and gyroscope (Block et al., 2016). It is beneficial when started during early rehabilitation phase.
Advantage:
· Safe
· Effective
· Improves gait function
· Reduces depressive symptoms
· Increases cardio respiratory fitness (Barak et al., 2016)
Barriers:
· Personal (depression)
· Environmental (lack of transportation) (Barak et al., 2016)
b) Weight management
Weight reduction is effective in post stroke depression. System CHANGETM aim is to motivate overweight stroke survivors to reduce their weight up to 5% and to improve health outcomes. It consist of 3 parts: Diet (more fruits and vegetables, avoid fatty food), sleep (recommended sleeping hours), physical activity (reduce inactive behaviour). System CHANGETM is more effective in encouraging behavioural changes compared to health education specialist (Plow et al.,