Depressive changes in stroke patients.

The present state of research concerning depressive alterations following cerebrovascular infarcts is reviewed with special consideration of methodological issues, the course of depressive changes and interactions with neuropsychological and clinical parameters. The concepts of 'grief response', '(depressive)-catastrophic reactions' and 'post-stroke depression' are analysed and compared. An attempt is made at a theory of post-stroke depressive alterations that is based on neuroanatomical, pathophysiological and neurochemical models of depression and psychosocial changes and interactions. Therapeutic implications are discussed.