RT Journal Article
SR Electronic
T1 Depression and its relation to lesion location after stroke
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 371
OP 374
DO 10.1136/jnnp.64.3.371
VO 64
IS 3
A1 Siobhan M MacHale
A1 Suzanne J O’Rourke
A1 Joanna M Wardlaw
A1 Martin S Dennis
YR 1998
UL http://jnnp.bmj.com/content/64/3/371.abstract
AB The study of discrete organic cerebral lesions resulting in clearly definable psychiatric disorders may provide an understanding of the underlying patho-physiological basis of these disorders. However, the relation between lesion location and psychiatric illness after stroke remains unclear. Fifty five patients referred to hospital were identified who had a single lesion on CT which was consistent with their neurological presentation and who did not have evidence of a persistent affective disorder at the time of the stroke. Six months after stroke standardised psychiatric assessment disclosed that 26% of the patients met DSM-IV criteria for an anxiety or depressive disorder, with depression the most common diagnosis (20%). Pathological emotionalism was diagnosed in 18% of patients, particularly those who were depressed (p<0.0001). Depression was significantly associated with larger lesions involving the right cerebral hemisphere (p=0.01). The importance of depression as a consequence of stroke has been clarified by the studies in this area. However, wide confidence intervals support the possibility that significant results may be due to chance. A systematic review of these studies is now needed if a consensus is to be reached.