卒中后抑郁的评估进展

卒中后抑郁发病率较高，准确的评估有利于临床诊疗。目前，对卒中后抑郁的评估多依赖量表。对于不影响语言表达的卒中患者，汉密尔顿抑郁量表、卒中后抑郁分级量表和蒙哥马利抑郁量表应用最为广泛，且其信度和效度均较高。对于失语患者的卒中后抑郁评价量表虽然开发的比较多，但临床应用相对较局限，其中卒中失语抑郁问卷和失语抑郁评估量表应用相对较多。目前针对卒中后抑郁评估量表的应用人群、评估指标有所差异，在应用这些量表时，相比原发疾病，评估者更重视抑郁情绪的问题，这可能会造成患者的不配合和排斥，从而影响量表评价的准确性，这些局限性有待进一步研究解决。

Progress in Assessment of Post-stoke Depression

The incidence of post-stroke depression (PSD) is high, and accurate assessment of
PSD is helpful for clinical diagnosis and treatment. At present, PSD is assessed by using various
scales. For stroke patients with normal speaking, Hamilton depression rating scale, post-stroke
depression rating scale, and Montgomery-Asberg depression rating scale are the most widely used,
which have high reliability and validity. For stroke patients with aphasia, although multiple PSD
assessment scales have been developed, scales that can be used in clinical practice are relatively
limited, of which the stroke aphasic depression questionnaire and the aphasic depression rating
scale are relatively widely used. The assessment scales for PSD have different suitable population
and evaluation indicators, what’s more, when using these scales, the raters pay more attention to
depression than the primary disease-stroke, which may make patients feel discomfort and reject
these evaluations so that the accuracy of the evaluation may be affected. Therefore, the limitations
of these scales need to be resolved according to patients’ need in the future.