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Phenomenological Characteristics of Poststroke Depression

Early- Versus Late-Onset

Received March 23, 2001; revised December 31, 2001, January 15, January 30, 2002; accepted January 30, 2002. From the Department of Psychiatry, University of Iowa College of Medicine, Iowa City, IA (AT, MK,RGR) and the Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan (AT,MK). Address correspondence to Dr. Robinson, Department of Psychiatry, The University of Iowa College of Medicine, 200 Hawkins Dr., #2887 JPP, Iowa City, IA 52242. e-mail: robert-robinson{at}uiowa.edu

OBJECTIVE: Authors compared poststroke major (n=17) or minor (n=28) depression diagnosed 3 to 6 months poststroke with major (n=16) or minor (n=22) depression diagnosed at 12 to 24 months to identify changes in the phenomenological characteristics of poststroke depression over time. METHODS: Depressive symptoms were divided into vegetative, psychological symptoms, and melancholic features elicited by the Present State Exam (PSE). Patients were also examined for severity of depression, social impairment, and neurological findings. RESULTS: Early-onset poststroke major depression was associated with a higher frequency of vegetative symptoms and larger lesion volume than late-onset major depression. Similarly, early-onset minor depression was associated with poorer social functioning and a higher frequency of melancholic, vegetative, and psychological symptoms than late-onset minor depression. CONCLUSION: These findings suggest that the phenomenological characteristics of both major and minor poststroke depression change over time and that both early-onset major and minor poststroke depression may result from similar etiological mechanisms provoked by brain injury.

Key Words: Depression • Stroke • Poststroke Depression

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