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To explore the relationship between self-esteem and functional recovery in patients with acute stroke.A nonconsecutive sample of stroke survivors received ratings of functional status and completed self-report measures of self-esteem and depressive symptoms. Bivariate correlational analyses and multivariate regression analyses explored the relationships of functional status and self-report of self-esteem and depressive symptoms.Acute inpatient rehabilitation hospital.A group of 176 right- or left-hemisphere stroke participants.Self-care and mobility domain scores (based on Functional Independence Measure ratings) at admission and discharge. Efficiency scores for each domain. Visual Analogue Self-Esteem Scale (S. M. Brumfitt & P. Sheeran, 1999) and Geriatric Depression Scale (J. A. Yesavage et al., 1983).Regression analyses indicated that lower self-esteem ratings were related to poorer discharge self-care and mobility scores and poorer efficiency in these domains, whereas ratings of depressive symptoms were not. However, interactions between self-esteem ratings and ratings of depressive symptoms were noted. Exploratory analyses suggested that self-esteem ratings mediated the relationship between ratings of depressive symptoms and functional outcome indices.Self-esteem ratings may have a mediating/moderating role in the relationship between emotional functioning and functional outcome. This may have implications for research in this area and the type of mental health treatment available to stroke rehabilitation patients.