Abstract :
Background : Stroke patients commonly suffer from neuropsychiatric disorders, such as depression,
that negatively influence stroke outcome. Diagnosis, treatment and prevention of post-stroke psychiatric
disorders including depression are under debate. Objective: To study the course of depression after stroke.
Methods: One hundred and ninety first-ever stroke patients were screened for depressive symptoms at 1, 3, 6, 9,
and 12 months after stroke. Diagnosis of depression was made according to the DSM-IV criteria of major and
minor depression. Results: Follow-up was completed in 138 patients. The cumulative incidence of post-stroke
depression (PSD) in 1 year was 36.2%. One month after stroke the prevalence of PSD was 18.8%. Thirty percent
of patients who were depressed in the first three months did not reach cut-off levels on depression screening
instruments at the following assessments. In 44% of these patients symptoms recurred. Recurrent cases were
older than patients with limited disease. In 40% of PSD patients depression persisted for at least two consecutive
following follow-up visits. Persistent cases were more disabled and suffered more often from major depression.
Conclusion: Half of PSD patients become depressed within the first month after stroke. Although most patients
recover, a clinician has to be aware that symptoms can recur especially in older patients and that in patients with
major depression symptoms may be persistent. In these patients treatment should be considered, whereas in
patients with limited disease an observational approach may suffice
