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Prospective studies of mood changes after stroke in large samples of patients may permit the delineation of the acute emotional behavioral changes that are markers for the delayed development of emotional disturbances. Mood disorders can be quantified using specifically designed scales, such as the Center for Epidemiological Studies-Depression (CES-D) or the Hospital Anxiety and Depression Scale (HADS), and may be predictors of the later development of depression. The standardized diagnostic criteria of the DSM-IV for mood disorders are appropriate for stroke, as poststroke depression has a similar symptomatic profile to primary depression. Fear and anxiety are common following stroke. Anxiety is the second most prevalent mood disorder following stroke, being found in 3.5%-24% of patients. Careful monitoring of stroke and measurement of monoamine metabolites and neuroexcitatory amino acids, may give a better understanding of the biological mechanism underlining poststroke emotional disturbances.
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