title: Poststroke depression correlates with cognitive impairment and neurological deficits.
abstract: OBJECTIVE
  The prevalence of poststroke depression is known to be high, but the knowledge of its neuropsychological correlates is limited. This 12-month prospective study was designed to evaluate the natural history 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 men, 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 depression 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 association 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 speed (P=0.020). The presence of dysphasia increased the risk of major depression. The depressive patients were more dependent in ADL and had more severe impairment and handicap than the nondepressive patients.
  
  
  CONCLUSIONS
  More than half of the patients suffer from depression after stroke, and the frequency of major depression seems to increase during the first year. In addition to dysphasia, poststroke depression is correlated with other cognitive deficits. We emphasize the importance of psychiatric evaluation of stroke patients.
authors.affiliation: Department of Neurology, University of Oulu, Finland. marja-liisa.kauhanen@fimnet.fi
authors.forename: M
authors.initials: M
authors.lastname: Kauhanen
authors.forename: J T
authors.initials: JT
authors.lastname: Korpelainen
authors.forename: P
authors.initials: P
authors.lastname: Hiltunen
authors.forename: E
authors.initials: E
authors.lastname: Brusin
authors.forename: H
authors.initials: H
authors.lastname: Mononen
authors.forename: R
authors.initials: R
authors.lastname: Määttä
authors.forename: P
authors.initials: P
authors.lastname: Nieminen
authors.forename: K A
authors.initials: KA
authors.lastname: Sotaniemi
authors.forename: V V
authors.initials: VV
authors.lastname: Myllylä
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000209:etiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D009483:Neuropsychological Tests; D015995:Prevalence; D011446:Prospective Studies