Stroke represents a major public health problem in the United States, but relatively little work has been directed toward identifying and treating the common neuropsychiatric disorders occurring after stroke. This review discusses clinical and pathological correlates of depression, anxiety disorder, catastrophic reactions, pathological affect, or psychosis after stroke, as well as their epidemiology. Depressive disorder and anxiety disorder have been shown to inhibit physical recovery from stroke. It seems likely that other psychiatric disorders also inhibit recovery and limit quality of life. There are very few controlled trials examining the effectiveness of treatments for these disorders after stroke. Both depression and pathological affect, however, can be effectively treated with antidepressant medications.