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March 1988

Comparison of Patients With and Without Poststroke Major Depression Matched for Size and Location of Lesion

Author Affiliations

From the Departments of Psychiatry and Behavioral Sciences (Drs Starkstein and Robinson) and Neurosciences (Dr Robinson), The Johns Hopkins University School of Medicine, and the Department of Neurology, University of Maryland School of Medicine (Dr Price), Baltimore.

Arch Gen Psychiatry. 1988;45(3):247-252. doi:10.1001/archpsyc.1988.01800270061007

• Patients who developed major depression within two years following stroke (n = 13) were compared with patients who did not become depressed in the same period (n = 13) but who did have a similar size and location of lesion as in the depressed group. Although the depressed patients were not significantly different from the nondepressed patients in background characteristics, history of depressive disorder, neurological impairment, or social functioning, the depressed group had greater cognitive impairment as measured by Mini-Mental State score. In addition, the depressed group had significantly larger lateral and third ventricular to brain ratios than nondepressed patients on computed tomographic scan analysis. The results suggest that poststroke depression itself may produce an intellectual impairment; subcortical atrophy, which likely preceded the stroke lesion, may produce a vulnerability for depression following stroke.