[Depressive disorders after cerebral infarct. Relations to infarct site, brain atrophy and cognitive deficits]

We studied the effects of the localisation and size of ischemic brain infarcts and the influence of potential covariates (gender, age, time since infarction, physical handicap, cognitive impairment, aphasia, cortical atrophy and ventricular size) on 'post-stroke depression'. During an 18-months period all patients who underwent a CT-scan at the Central Institute of Mental Health and who had a single unilateral ischemic hemisphere infarct were initially included. Patients with severe aphasia or cognitive impairment who could not communicate well enough for the administration of depression rating scales were excluded. This led to a selection bias towards larger infarct sizes in the right hemisphere. In order to overcome this potentially critical selection artefact all patients with infarct sizes over 23 cm2 and/or with 'mini Mental State Scores' under 20 were excluded. The data from the remaining 30 patients (mean age 68 years; 15 male; 13 left hemisphere infarcts were used for the analysis. Their scores on the Hamilton depression rating scale, the Zung self rating depression scale and the von Zerssen clinical self-rating depression scale correlated significantly with one another (r greater than 0.73; p less than 0.001). Backward stepwise regression analysis carried out on the covariates mentioned above demonstrated a significant relationship only between cognitive impairment or cortical atrophy and a higher depression score.(ABSTRACT TRUNCATED AT 250 WORDS)