DEPRESSION AND ITS RELATION TO LESION LOCATION AFTER STROKE

The study of discrete organic cerebral lesions resulting in clearly de finable psychiatric disorders may provide an understanding of the unde rlying pathophysiological basis of these disorders. However, the relat ion between lesion location and psychiatric illness after stroke remai ns unclear. Fifty five patients referred to hospital were identified w ho had a single lesion on CT which was consistent with their neurologi cal presentation and who did not have evidence of a persistent affecti ve disorder at the time of the stroke. Six months after stroke standar dised psychiatric assessment disclosed that 26% of the patients met DS M-IV criteria for an anxiety or depressive disorder, with depression t he most common diagnosis (20%). Pathological emotionalism was diagnose d in 18% of patients, particularly those who were depressed (p<0.0001) . Depression was significantly associated with larger lesions involvin g the right cerebral hemisphere (p=0.01). The importance of depression as a consequence of stroke has been clarified by the studies in this area. However, wide confidence intervals support the possibility that significant results may be due to chance. A systematic review of these studies is now needed if a consensus is to be reached.