Post-stroke depressive disorders: a follow-up study of 103 patients.

One hundred three patients attending a stroke clinic were evaluated for post-stroke depressive disorders using repeated quantitative assessment of psychopathology during a 12 month period. Almost one-third of these patients were depressed at the time of the initial assessment and two-thirds of these depressed patients who were re-evaluated remained depressed for 7 to 8 months. The prevalence and severity of depressive disorders was significantly elevated in those patients who were between 6 months and 2 years post-stroke. Demographic variables however did not distinguish depressed and non-depressed patients, nor did type of neurological symptoms, degree of impairment in activities of daily living or global cognitive impairment. However, patients with left hemisphere brain injury were significantly more depressed than patients with right hemisphere or brain stem infarctions. Based on this work and previous studies, we have suggested a profile for patients who are at high risk for developing post stroke depressive disorders: patients with left hemisphere frontal lobe infarctions who are within 2 years of the stroke. In spite of the fact that these depressions were clinically significant, none of the patients were presently receiving treatment. Effective treatment methods for these patients need to be developed.