Poststroke depression correlates with cognitive impairment and neurological deficits

Background and Purpose-The prevalence of poststroke depression is known to be high, but the knowledge of its neuropsychological con-elates is limited. This 12-month prospective study was designed to evaluate the natural histo ry of poststroke depression and to study its neuropsychological, clinical, and functional associates. Methods-We studied a series of 106 consecutive patients (46 women and 60 me n, mean age 65.8 years) with acute first-ever ischemic stroke. The patients underwent a neurological, psychiatric, and neuropsychological examination at 3 and 12 months after the stroke. The psychiatric diagnosis of depressio n was based on DSM-III-R-criteria. Results-Depression was diagnosed in 53% of the patients at 3 months and in 42% of the patients at 12 months after the stroke. The prevalence of major depression was 9% at 3 months and 16% at 12 months, There was an associatio n between poststroke depression and cognitive impairment; the domains most likely to be defective in stroke-related depression were memory (P = 0.022) , nonverbal problem solving (P = 0.039), and attention and psychomotor spee d (P = 0.020). The presence of dysphasia increased the risk of major depres sion. The depressive patients were more dependent in ADL and had more sever e impairment and handicap than the nondepressive patients. Conclusions-More than half of the patients suffer from depression after str oke, and the frequency of major depression seems to increase during the fir st year. In addition to dysphasia, poststroke depression is correlated with other cognitive deficits, We emphasize the importance of psychiatric evalu ation of stroke patients.