Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jun 19, 2020; 10(6): 125-138
Published online Jun 19, 2020. doi: 10.5498/wjp.v10.i6.125
Neuropsychiatric issues after stroke: Clinical significance and therapeutic implications
Yan Ma, Juan Feng, Zhi-Jun Liu, Michael Xu, Shuo Zhang
Shuo Zhang, Juan Feng, Department of Neurology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Michael Xu, Department of Clinical Medicine, International Education School, China Medical University, Shenyang 110004, Liaoning Province, China
Zhi-Jun Liu, Yan Ma, Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Zhang S, Feng J and Liu ZJ conceived and designed the review; Xu M, Feng J, Ma Y and Zhang S reviewed and edited the manuscript; Zhang S and Liu ZJ wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81801712, No. 81801710, No. 81771271; the Science and Technology Project Funds from Education Department of Liaoning Province of China, No. LK2016022.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Zhi-Jun Liu, MD, PhD, Assistant Professor, Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao Street Heping District, Shenyang 110004, Liaoning Province, China.
Received: December 30, 2019
Peer-review started: December 30, 2019
First decision: March 24, 2020
Revised: April 17, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: June 19, 2020

A spectrum of neuropsychiatric disorders is a common complication from stroke. Neuropsychiatric disorders after stroke have negative effects on functional recovery, increasing the rate of mortality and disability of stroke survivors. Given the vital significance of maintaining physical and mental health in stroke patients, neuropsychiatric issues after stroke have raised concerns by clinicians and researchers. This mini-review focuses on the most common non-cognitive functional neuropsychiatric disorders seen after stroke, including depressive disorders, anxiety disorders, post-traumatic stress disorder, psychosis, and psychotic disorders. For each condition, the clinical performance, epidemiology, identification of the therapeutic implication, and strategies are reviewed and discussed; the main opinions and perspectives presented here are based on the latest controlled studies, meta-analysis, or updated systematic reviews. In the absence of data from controlled studies, consensus recommendations were provided accordingly.

Keywords: Stroke, Neuropsychiatric disorders, Depression, Anxiety, Post-traumatic stress disorder, Psychosis

Core tip: The purpose of this mini-review is to summarize the research advance of neuropsychiatric disorders including depressive disorders after stroke, anxiety disorders after stroke, post-traumatic stress disorder after stroke, post-stroke psychosis, and psychotic disorders. Recent evidence showed that neuropsychiatric disorders after stroke are associated with worsened outcomes yet are still under-recognized. With the exception of depressive disorders after stroke, the other neuropsychiatric disorders lack reliable and high-quality evidence in clinical practice. Further studies should attempt to develop protocols or guidelines for the diagnosis, treatment, or prevention of neuropsychiatric disorders after stroke.