Abstract
The purpose of this study was to investigate the relationship between background epidemiological, neuroanatomical and cognitive factors and perception o f one’s impairment and disability with post stroke depression. Thirty first-ever stroke patients with no previous psychiatric history, or with history of functional or intellectual declines and with the ability to be interviewed reliably were studied. Epidemiological, neuroanatomical, and psychometric data together with self ratings of impairment and disability covering five cognitive domains (general intelligence, attention, memory, visuoperceptual skills and executive functioning) plus self reported depression scores were collected. No associations were found between the epidemiological factors, neuroanatomical correlates and psychometric measurements with depression. But significant relationships were found between individual’s visual analogue ratings of impairment and disability with depression scores. An explanation for this phenomenon was proposed. However, it was impossible to determine whether distorted perception of own impairment and disability leads to depression, or depression precipitates the distorted perception. The findings raised the issue of reality testing, especially in current practice where the focus is on physical aspects of recovery at the expenses of cognitive functioning. Proposal to alter this was made.