Post Stroke Causing Sequelae Known as Major Depressive Disorder: A Comprehensive Review

Stroke is a leading cause of disability worldwide, often associated with neuropsychiatric sequelae such as Major Depressive Disorder (MDD). Post-stroke depression (PSD) significantly impacts recovery, quality of life, and overall prognosis, yet it remains underdiagnosed and undertreated. This review aims to comprehensively examine the pathophysiology, prevalence, risk factors, clinical features, and management strategies for MDD following stroke, providing insights into its profound impact on recovery and long-term outcomes. A literature search was conducted using PubMed, Scopus, and Web of Science databases, focusing on studies published in the past 15 years. Keywords included "stroke," "post-stroke depression," and "neuropsychiatric sequelae." Articles examining the prevalence, pathophysiology, diagnostic criteria, and management of PSD were included. The prevalence of MDD among stroke patients ranges from 20% to 50%, with higher rates observed in individuals with severe strokes and limited social support. Pathophysiological mechanisms involve dysregulation of neurochemical pathways, inflammation, and neuroanatomical damage to regions like the prefrontal cortex. MDD delays functional recovery, increases the risk of stroke recurrence, and worsens mortality outcomes. Diagnostic challenges arise due to symptom overlap with stroke sequelae. Management includes pharmacological interventions such as selective serotonin reuptake inhibitors (SSRIs), non-pharmacological approaches like cognitive-behavioural therapy, and comprehensive rehabilitation programs integrating mental health care. MDD is a critical but often overlooked complication of stroke. Early screening, multidisciplinary approaches, and individualised treatment strategies are essential to improve patient outcomes. Further research is needed to explore biomarkers, cultural variations, and long-term efficacy of current therapies.