The Italian multicenter observational study depression in stroke (DESTRO) aimed to identify risk factors for post stroke depression (PSD) and quantify the likelihood of it arising in various categories of patients. Mood evaluation was performed in 1064 consecutive stroke patients by means of Beck Depression Inventory and Visual Analog Mood Scale. Depressive symptoms were classified using the DSM-IV and revised WHO criteria for depression in the course of a neurological disorder. Post stroke depression was seen in 36% of the survivors, with dysthymia by far the predominant form (80.7%). Female sex, disability, previous cerebrovascular or depressive episodes were significantly associated with an increased risk of depression. Combinations of these factors raised the risk of PSD exponentially, from 24.3 to 89.1%. The site of the stroke did not come into the uni- or multivariate analysis. At admission, it is possible to predict the likelihood of PSD and quantify the relative risk.