Suicidal ideation and attempts in patients with stroke: a population-based study

Abstract

Stroke is known to be associated with an increase in the risk for suicide. However, there are very few population-based studies investigating the risk of suicidal ideation and attempts in patients with stroke. The purpose of this study was to compare the risk of suicidal ideation and attempts between patients with stroke and population without stroke using nationwide survey data. Individual-level data were obtained from 228,735 participants (4560 with stroke and 224,175 without stroke) of the 2013 Korean Community Health Survey. Demographic characteristics, socioeconomic status, physical health status, and mental health status were compared between patients with stroke and population without stroke. Multivariable logistic regression was performed to investigate the independent effects of the stroke on suicidal ideation and attempts. Stroke patients had more depressive mood (12.6 %) than population without stroke (5.7 %, p < 0.001). Stroke patients experienced more suicidal ideation (24.4 %) and attempts (1.3 %) than population without stroke (9.8 and 0.4 %, respectively; both p < 0.001). Stroke was found to increase the risk for suicidal ideation (OR 1.65, 95 % CI 1.52-1.79) and suicidal attempts (OR 1.64, 95 % CI 1.21-2.22), adjusting for demographics, socioeconomic factors, and physical health and mental health factors. We found that stroke increased the risk for suicidal ideation and attempts, independent of other factors that are known to be associated with suicidality, suggesting that stroke per se may be an independent risk factor for suicidality.

Rates and correlates of suicidal ideation among stroke survivors: a meta-analysis

“…All studies were written in English language and were conducted in Brazil,30 Canada,9 21 China,22 31 Finland,26 Hong Kong,27–29 Korea,8 14 24 New Zealand,23 Portugal15 and USA 25. Sample sizes ranged between 7330 and 45608 individuals. Assessment of suicidal ideation was completed at very different points in time after stroke, varying from a few days15 22 24 25 31 to several months,21 23 26–30 using heterogeneous methods including single-item tests, Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSI), General Health Questionnaire (GHQ), Geriatric Mental State Examination (GMS), Hamilton Depression Rating Scale (HDRS), Montgomery Asberg Depression Rating Scale (MADRS), Patient Health Questionnaire (PHQ), Present State Examination (PSE) and Structured Clinical Interview for DSM (SCID).…”

Gender-specific factors related to suicidal ideation among community-dwelling stroke survivors: The 2013 Korean Community Health Survey

“…Previous studies have described an increased risk of suicide among stroke survivors [ 4 , 5 ]. Compared with subjects who had not suffered a stroke, those who had were found to be at increased risk of suicidal ideation and attempted suicide [ 6 ]. Thus, the identification of factors associated with suicidal ideation after stroke is an important clinical and public health issue.…”

Suicidal drug overdose following stroke in elderly patients: a retrospective population-based cohort study

“…Patients with stroke had a higher risk of attempting suicide (odds ratio: 1.64, 95% CI: 1.21–2.22). 36 Furthermore, we found that the risk of SDO significantly increased with the number of stroke events. Older patients with more than four strokes had the highest cumulative incidence of SDO ( Figure 3 ).…”