Vascular depression: where do we go from here?

Vascular depression has been the topic of many studies since its revival at the end of the last century. Several important conclusions can be drawn from this research. First, from a conceptual point of view, it is a potentially valuable eiotological based new entity. Second, vascular depression encompasses not only depression with small vessel disease of the brain, but also poststroke depression, and depression related to myocardial infarction should be placed in this same category of vascular depression. Third, the treatment outcome and natural course of vascular depression have been much worse than that of the nonvascular depression. Fourth, more research on vascular depression is needed, especially on interventions. Poststroke antidepressant and psychoeducation therapy and vascular preventive interventions can probably improve outcome.