Depression and cerebrovascular disease.

Depressive disorder is a common complication of stroke. Although somatic symptoms of stroke may be mistaken for depression, DSM-III criteria for major depression are appropriate for use in this clinical setting. The etiology of poststroke depression can be viewed from a number of perspectives. Evidence from examining lesion characteristics and depression suggests that a disease model is suitable for some cases of poststroke depression. Alternatively, adequacy of social support and gender differences influence the occurrence of poststroke depression. Poststroke depression can be effectively treated with tricyclic antidepressants, and the use of these agents may also enhance physical and cognitive recovery.