Another issue related to the course of poststroke depression is time of onset of depression. Why do some patients develop depression during the acute poststroke period while other patients develop it several months or even years following stroke. We have recently examined this issue using our group of 142 patients with longitudinal follow-up to determine the frequency of acute- versus delayed-onset major and minor depression during the first 2 years following stroke. The follow-up evaluations were conducted at 3, 6, 12, and 24 months following stroke.

The background characteristics of the patients are shown in Table 9.1. Patients who developed major depression during the acute poststroke period tended to be younger than those who developed delayed-onset major depression, although the age distribution across diagnostic groups was not significantly different. There was no significant difference in the frequency of major versus minor depression among patients with acute- or delayed-onset depression.

There were no significant differences in any of the other background characteristics or previous history of psychiatric disorder. Similarly, there were no significant differences between groups in the use of medications; that is, antihypertensives, steroids, psychotropics, or other drugs. Two of the patients with acute depressions and one with delayed-onset depression were receiving antidepressant medication.