In the acute phase of cerebral ischemia, 55% of the patients showed signs of mild depression after a period of 5-9 days. The development and intensity of depressive symptoms correlated strongly with the grade of functional impairment. A statistically less significant relationship was established between the depressive symptoms and low social status, higher age, lower predisease intelligence and accompanying symptoms of anxiety. Independent of antidepressive therapy, after 4 weeks an improvement in the initially registered functional and intellectual impairment as well as the depressive symptoms (prevalence rate 23.3%) was recorded. None of these parameters correlated with each other in any way. In conclusion, we interpreted these depressive symptoms as the result of reactive coping strategies during the acute phase of cerebral ischemia. In contrast to this, the aspect of gender showed no significant relationship to the resulting depressive symptoms. Furthermore, lesion location, lesion volume, and cortical atrophy and cognitive impairment proved to have no influence on depressive symptoms. This suggests that primary organic factors are not the cause of depression in connection with the acute stroke period.