Bipolar disorder and the risk for stroke incidence and mortality: a meta-analysis

Yuan, Min; Xiao, Zhilong; Zhou, Huang-Yan; Rao, Wei; Huang, Gang; Nie, Hongbing; Cao, Weijun; Xu, Renshi

doi:10.1007/s10072-021-05348-2

Cited by 11 publications

(15 citation statements)

References 41 publications

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“…11,12 Moreover, several studies have associated MHCs with increased IS risk regardless of the presence of AF; however, our study does not confirm these findings in AF patients. [7][8][9][10] Although previous research on mortality in AF patients with MHCs is limited, our results of higher mortality in patients with depression, schizophrenia and any MHC are in concordance with reports of higher mortality in these patients regardless of the presence of AF. 7,[18][19][20] Especially, schizophrenia has been associated with poor overall survival, corresponding with our observation of more than 50% higher adjusted mortality in AF patients with schizophrenia, when compared to patients without MHC.…”

Section: Discussionsupporting

confidence: 91%

“…Our principal findings of similar IS risk in AF patients with MHCs are in line with the findings by Søgaard et al but in contrast with the pooled results of the recent meta‐analysis 11,12 . Moreover, several studies have associated MHCs with increased IS risk regardless of the presence of AF; however, our study does not confirm these findings in AF patients 7–10 . Although previous research on mortality in AF patients with MHCs is limited, our results of higher mortality in patients with depression, schizophrenia and any MHC are in concordance with reports of higher mortality in these patients regardless of the presence of AF 7,18–20 .…”

Section: Discussionsupporting

confidence: 77%

“…The well‐validated CHA 2 DS 2 ‐VASc score is used to identify patients at high risk of stroke and indicated to receive OACs for stroke prevention; however, there are several other stroke risk factors that are not included in this score, such as impaired renal function, malignancies and dyslipidaemia 6 . Interestingly, mental health conditions (MHCs), particularly depression, bipolar disorder, anxiety disorder and schizophrenia, have been shown to increase IS risk, regardless of the presence of AF 7–10 . However, in patients with AF, the evidence on the impact of these MHCs on the incidence of IS and mortality is limited and has shown inconsistent results 11–13 .…”

Section: Introductionmentioning

confidence: 99%

“…6 Interestingly, mental health conditions (MHCs), particularly depression, bipolar disorder, anxiety disorder and schizophrenia, have been shown to increase IS risk, regardless of the presence of AF. [7][8][9][10] However, in patients with AF, the evidence on the impact of these MHCs on the incidence of IS and mortality is limited and has shown inconsistent results. [11][12][13] Additionally, AF patients with MHCs are less likely to receive OAC therapy for stroke prevention than patients without MHC, but the impact of this poorer OAC coverage on outcomes is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Mental health conditions and risk of first‐ever ischaemic stroke and death in patients with incident atrial fibrillation: A nationwide cohort study

Teppo

Jaakkola

Biancari

et al. 2022

Eur J Clin Investigation

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Background: Atrial fibrillation (AF) patients with mental health conditions (MHCs) have higher incidence of ischaemic stroke (IS) than patients without MHC, but whether this results from direct impact of MHCs or relates to higher prevalence of comorbidities and differences in the use of oral anticoagulant (OAC) therapy is unclear. We assessed the hypothesis that MHCs independently increase the risk of IS in patients with incident AF. Methods: The nationwide FinACAF cohort covered all 203,154 patients diagnosed with incident AF without previous IS or transient ischaemic attack in Finland during 2007-2018. MHCs of interest were depression, bipolar disorder, anxiety disorder, schizophrenia and any MHC. The outcomes were first-ever IS and all-cause death.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mental health conditions and risk of first‐ever ischaemic stroke and death in patients with incident atrial fibrillation: A nationwide cohort study

Teppo

Jaakkola

Biancari

et al. 2022

Eur J Clin Investigation

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“…1,2 Clinically, people affected by both conditions are less likely to receive either adequate stroke or psychiatric care 3,4 indicating a clear need to develop the evidence-base and clinical pathways. However, research on strokepsychosis comorbidity is limited to cohort studies focusing on stroke risk in people with schizophrenia 5 and bipolar disorder 6 diagnoses, while the majority of publications on psychosis after stroke are single case studies. 7 Although psychosis has been frequently described as a "rare" complication of stroke, 8 a meta-analysis of post-stroke psychosis reported the prevalence of delusion and hallucination to be 4.67% and 5.05%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal associations between stroke and psychosis: a population-based study

Richards-Belle

Poole

Osborn

et al. 2022

Preprint

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Background: The co-occurrence of stroke and psychosis is a serious neuropsychiatric condition, but little is known about the course of this comorbidity. Aims: To estimate longitudinal associations between stroke and psychosis over 10 years. Methods: A 10-year population-based study using data from the English Longitudinal Study of Ageing. A structured health assessment recorded i) first-occurrence stroke and ii) psychosis, at each wave. Each were considered exposures and outcomes in separate analyses. Logistic and Cox proportional hazards regression and Kaplan-Meier methods were used. Models were adjusted for demographic and health behaviour covariates, with missing covariates imputed using random forest multiple imputation. Results: Of 19,808 participants, 24 reported both stroke and psychosis (median Wave 1 age 63, 71% female, 50% lowest quintile of net financial wealth) at any point during follow-up. By 10 years, the probability of an incident first stroke in participants with psychosis was 21.4% (95% CI, 12.1 to 29.6) compared to 8.3% (95% CI, 7.8 to 8.8) in those without psychosis (absolute difference: 13.1%; 95% CI, 20.8 to 4.3, log rank p<0.001; fully-adjusted hazard ratio (HR): 3.63; 95% CI, 2.25 to 5.87). The probability of reporting incident psychosis in participants with stroke was 2.3% (95% CI, 1.4 to 3.2) compared to 0.9% (95% CI, 0.7 to 1.1) in those without (absolute difference: 1.4%; 95% CI, 0.7 to 2.1, log rank p<0.001; fully-adjusted HR: 5.81; 95% CI, 2.89 to 11.70). Conclusions: Stroke is an independent predictor of psychosis (and vice versa), after adjustment for potential confounders.

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Mood swings are causally associated with intracranial aneurysm subarachnoid hemorrhage: A Mendelian randomization study

Peng,

Li,

Adegboro

et al. 2023

Brain and Behavior

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BackgroundMood swings have been observed in patients with intracranial aneurysm (IA), but it is still unknown whether mood swings can affect IA.AimTo explore the causal association between mood swings or experiencing mood swings and IA through a two‐sample Mendelian randomization (MR) study.MethodsSummary‐level statistics of mood swings, experiencing mood swings, IA, aneurysm‐associated subarachnoid hemorrhage (aSAH), and non‐ruptured IA (uIA) were collected from the genome‐wide association study. Two‐sample MR and various sensitivity analyses were employed to explore the causal association between mood swings or experiencing mood swings and IA, or aSAH, or uIA. The inverse‐variance weighted method was used as the primary method.ResultsGenetically determined mood swings (odds ratio [OR] = 5.23, 95% confidence interval (95%CI): 1.65–16.64, p = .005) and experiencing mood swings (OR = 2.50, 95%CI: 1.37–4.57, p = .003) were causally associated with an increased risk of IA. Mood swings (OR = 5.67, 95%CI: 1.40–23.04, p = .015) and experiencing mood swings were causally associated with the risk of aSAH (OR = 2.91, 95%CI: 1.47–5.75, p = .002). Neither mood swings (OR = 1.95, 95%CI: .31–12.29, p = .478) nor experiencing mood swings (OR = 1.20, 95%CI: .48–3.03, p = .693) were associated with uIA.ConclusionsMood swings and experiencing mood swings increased the risk of IA and aSAH incidence. These results suggest that alleviating mood swings may reduce IA rupture incidence and aSAH incidence.

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Bipolar disorder and the risk for stroke incidence and mortality: a meta-analysis

Cited by 11 publications

References 41 publications

Mental health conditions and risk of first‐ever ischaemic stroke and death in patients with incident atrial fibrillation: A nationwide cohort study

Mental health conditions and risk of first‐ever ischaemic stroke and death in patients with incident atrial fibrillation: A nationwide cohort study

Longitudinal associations between stroke and psychosis: a population-based study

Mood swings are causally associated with intracranial aneurysm subarachnoid hemorrhage: A Mendelian randomization study

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