中风后精神健康障碍:印度的一种情况

Abhilash Patra, Dr. Sureshkumar Kamalakannan, Hira Pant, V. Agiwal, Nirupama A.Y., Sirshendu Chaudhuri, G. Murthy
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摘要

据报告,33%以上的中风幸存者存在精神健康障碍,这导致合并症增加、护理延迟、影响康复以及影响身体和社会功能。此外,它降低了生活质量,并对其家庭和照顾者的福祉产生影响。然而,现有的用于诊断脑卒中后精神健康障碍的筛查工具发现了许多未确诊和少报的脑卒中幸存者。在全球和印度,卒中后抑郁和焦虑非常普遍。假性球影响(PBA)在世界范围内从11%到34%不等。然而,在印度,只有少数病例报告报道了中风后精神病、躁狂和PBA。尽管发达国家存在筛查、转诊和精神健康障碍康复的指导方针,但印度缺乏这方面的资源。此外,地区心理健康计划(DMHP)收到了关于其成功和缺点的相互矛盾的评估。因此,这种情况强调需要强有力的循证战略,以制定适合印度国情的有效筛查、转诊和康复指南。此外,通过利用现有资源并与该领域的专家合作,印度可以制定一种全面有效的方法来解决中风后精神健康障碍问题。
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Mental Health Disorders Post-Stroke: A Scenario in India
Mental health disorders were reported in more than 33% of stroke survivors, which lead to increased comorbidities, delayed care, affect recovery, and impact physical and social functioning. Furthermore, it diminishes the quality of life and has impact on the well-being of both their families and caregivers. However, existing screening tools available for diagnosis of mental health disorders post-stroke detect many undiagnosed and underreported stroke survivors. Globally and in India, there has been a significant prevalence of post-stroke depression and anxiety. Pseudobulbar affect (PBA) ranged from 11% to 34%, worldwide. However, in India, only few case reports were reported for post-stroke psychosis, mania, and PBA. Although guidelines exist in developed countries for screening, referral, and rehabilitation of mental health disorders, there are lack of such resources in India. Also, the District Mental Health Program (DMHP) has received conflicting evaluations regarding its successes and shortcomings. Hence, this situation highlights the need for robust evidence-based strategies to develop effective screening, referral, and rehabilitation guidelines tailored to the Indian context. Also, by leveraging existing resources and collaborating with experts in the field, India can develop a comprehensive and effective approach to addressing post-stroke mental health disorders.
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