The validity of observed depression as a criteria for mood disorders in patients with acute stroke.

The validity of observed depression as a criteria for major or minor depression was assessed among 301 patients with acute stroke. Patients who acknowledged a depressed mood or loss of interest (standard depression) were compared to patients who denied depression but were 'observed' to be depressed (non-standard depression) for the clinical correlates of depression. Although standard and non-standard major depressions had some clinical correlates such as increased frequency of female gender and prior psychiatric history, standard major depression patients had a significantly higher frequency of left hemisphere lesions than the non-standard major depression patients. These results support the validity of 'observed' depression as a criteria for major depression but also suggest the possibility that failure to report depressed mood may identify a condition with a different etiology than depression that is recognized and acknowledged. Observed depression, however, was not validated among patients with minor depression since there were no clinical or phenomenological differences from non-depression.