"Our study found that post-stroke depression is not only caused by damage to the brain tissue but also depends on one's general tendency to react to distressing life events by experiencing emotions such as anger, anxiety and sadness," says lead author Ivo Aben, M.D. Aben was a Ph.D. student while conducting his research at the Institute of Brain and Behavior at Maastricht University, the Netherlands.

The researchers evaluated 190 people recovering from a first stroke for depressive symptoms at one, three, six, nine, and twelve months after the stroke. Survivors also completed questionnaires covering the tendency to experience negative mood states -neuroticism, extraversion, openness to new experiences, agreeableness, and conscientiousness. They responded to statements such as "I seldom feel lonely or sad," "I smile easily," and "I really like talking to people" on a five-point scale ranging from "strongly agree" to "strongly disagree."

Twelve months after their strokes, 38.7 percent of the survivors were depressed. Those with high neuroticism scores had a 4.6 times higher risk of developing depression than those with low scores. This effect was stronger in men than in women.

Neuroticism was the only personality trait that increased the risk of post-stroke depression. The survivor's level of disability was the only other factor that had an independent risk of increasing post-stroke depression.

The effect of negative emotions was independent of other factors such as patients' age, gender, location of stroke, level of disability and a prior episode of depression.

Dr. Aben commented that future research should also examine whether early psychological interventions such as emotional support and alternative coping strategies in survivors with high levels of neuroticism can prevent depression.