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Post-stroke depression — DGM MCQ

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ModerateStroke and rehabilitationPost-stroke depressionDGM

An 83-year-old woman is tearful and withdrawn three months after stroke. She has poor sleep, guilt and loss of interest in rehabilitation. There is no fluctuation or acute infection. Current medicines include clopidogrel and ramipril. What is the most likely diagnosis?

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Correct answer: E — Post-stroke depression

Persistent low mood, anhedonia, sleep disturbance and guilt after stroke suggest post-stroke depression. Delirium fluctuates acutely, pseudobulbar affect causes involuntary emotional expression, vascular dementia is cognitive, and drug-induced Parkinsonism causes motor features. Mood disorders are common barriers to stroke rehabilitation.

Reference: NICE NG236; NICE depression guidance