Nondysphoric depression following stroke.

Right hemisphere damage may influence the presentation of depressive disorders ensuing after stroke by disrupting emotion processing mechanisms. Three-hundred and one consecutive admissions for acute stroke were examined and subjects meeting previously validated criteria for nondysphoric depression (i.e., depressive ideation without endorsement of sad emotions) were compared to dysphoric depression, and to nondepressed patients. Compared to dysphoric depression, nondysphoric depression showed more frequent right anterior hemisphere lesions and more psychomotor slowing, self-depreciation, and severe sad affect. Psychopathological features and location of damage suggest that nondysphoric depression may be a special presentation of depressive disorder following stroke in which right hemisphere damage limits the apprehension of personal emotional changes.