Discriminative properties of somatic and nonsomatic symptoms for post stroke depression

While the existence of post stroke depression (PSD) is well established in the literature, the phenomenology of the disorder remains unclear. This study compared the discriminative validity of somatic and nonsomatic symptoms of depression as indicators of PSD. One hundred and eighty-nine persons who had a unilateral cerebrovascular accident (CVA) were administered a mood evaluation comprised of the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD) at least 4 weeks post stroke. Results indicated that the somatic items from both scales were significantly less specific when diagnosing PSD than were the nonsomatic (intrapsychic) items. Furthermore, the most accurate individual symptom indicators of PSD were nonsomatic, and somatic symptoms showed no incremental validity over intrapsychic symptoms for predicting PSD. Present findings suggest that clinicians, attempting to diagnose PSD, should rely more heavily upon nonsomatic symptoms than the somatic symptoms of depression. Furthermore, depression screening instruments for PSD should be constructed of primarily nonsomatic items.