Depression and Community Reintegration Post Stroke

Depression is a common complication post-stroke affecting approximately one-third of patients. The presence of post-stroke depression has been associated with decreases in functional recovery, social activity and cognition. In addition, the presence of mental health disorders following stroke may be associated with increased mortality. This chapter discusses the prevalence, natural history and risk factors for post-stroke depression as well as issues around its assessment and impact on rehabilitation outcomes. Strategies for the prevention and management of post-stroke depression are reviewed.
While the majority of stroke survivors return to live in the community, re-integration may be an enormous challenge. The ability to return to an acceptable lifestyle, participating in both social and domestic activities is important for perceived quality of life. The chapter will also examine issues arising following discharge from hospital care or rehabilitation into the community. These include social support, impact of caregiving on informal carers, family functioning, provision of information and education, leisure activities, driving, sexuality and return to work.