Depression and Cerebrovascular Disease: a phenomenological study

The main topic of this thesis is the clinical presentation of depression in subjects with cerebrovascular disease. It concerns patients with post-stroke depression, depression in subjects with vascular risk factors or in subjects with vascular lesions on MRI- or CT-scan. Some of the studies presented do indicate that there might be a specific symptom profile of depression in these subjects. These subjects show more so-called 'motivational' symptoms of depression and less 'mood' symptoms. This relation is more prominent in a clinical sample. In population-based studies, we only found this relation in one study, but could not confirm it in another. The motivational symptoms are also found to be related to more prominent cognitive disturbances in stroke or vascular subjects. In the general discussion the complex relation between vascular damage of the brain and its cognitive and affective consequences is described. Various levels of explanation are at hand and! the findings of this study could contribute to a part of the complex, explanatory etiological pathway that leads to development of post-stroke and vascular depression or dementia.

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