Depression may be a problem for a patient who has had a stroke. The risk for depression is affected by the presence of a number of factors, whose impact may vary with the time interval after the stroke.


Risk factors associated with post-stroke depression:

(1) family history of depressive, neurotic or anxiety disorder

(2) personal history of depressive, neurotic or anxiety disorder

(3) negative life events in the 6 months prior to the stroke (which would be a risk factor for pre-stroke depression)

(4) greater physical disability (impairment in activities of daily living, ADL)

(5) greater cognitive/intellectual impairment

(6) poor social support (living alone and few social contacts)

(7) history of previous stroke

(8) history of active alcohol abuse


Risk factors showing variable results between studies:

(1) location of the stroke (below)

(2) older age

(3) gender


Location of the stroke (Robinson, 2000, pages 1609):

(1) A stroke in the left frontal cortex or left basal ganglia is associated with major depression between 2 weeks and 2 months after the stroke.

(2) A stroke in the right frontal or right parietal cortices may be associated with depression.

(3) After 3 months the risk for depression was similar for both left and right-sided strokes.

(4) A patient with a recurrent stroke and with the previous stroke in the left frontal cortex or left basal ganglia (#1, above) has a high risk of depression, regardless of the location of the new stroke.


The impact of risk factors may vary with time interval after the stroke (Provinciali et al, 2002):

(1) In the first 3 months after the stroke, left anterior lesion (associated with language dysfunction) and living alone are important.

(2) After 3 months impairment in ADL is important.

(3) At 2-3 years post-stroke poor social contacts is important.


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