Predictors of Suicidal Ideation after Stroke?
Post-stroke depression is considered one of the common neuropsychiatric complications of cerebrovascular stroke, affecting approximately one third of stroke survivors at any one time after stroke (1). The risk of suicide also increases in post-stroke survivor with a following findings from a meta-analysis looking at over 2 million stroke survivors:
- Compared to the non-stroke group, the pooled adjusted RR of suicide in stroke survivors was 1.73, with a significantly higher adjusted risk of suicide attempt than of death by suicide. (2)
This recent study published by Sudhakar et al in the Journal of Affective Disorders Reports attempted to identify specific subgroups at higher risk of suicide in the early post-stroke period.
Here is the summary of this study’s clinically relevant points:
- Towfighi A, Ovbiagele B, El Husseini N, Hackett ML, Jorge RE, Kissela BM, Mitchell PH, Skolarus LE, Whooley MA, Williams LS; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Poststroke Depression: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2017 Feb;48(2):e30-e43. PMID: 27932603.
- Vyas MV, Wang JZ, Gao MM, Hackam DG. Association Between Stroke and Subsequent Risk of Suicide: A Systematic Review and Meta-Analysis. Stroke. 2021 Apr;52(4):1460-1464. PMID: 33691505.
- Sudhakar Selvaraj, Seema Aggarwal, Constanza de Dios, Juliana Mendonca De Figueiredo, Anjail Z. Sharrief, Jennifer Beauchamp, Sean I. Savitz, Predictors of suicidal ideation among acute stroke survivors, Journal of Affective Disorders Reports, Volume 10, 2022, 100410, ISSN 2666-9153 (article)
- Medeiros GC, Roy D, Kontos N, Beach SR. Post-stroke depression: A 2020 updated review. Gen Hosp Psychiatry. 2020 Sep-Oct;66:70-80. PMID: 32717644.
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Post-stroke depression is associated with higher mortality, poorer recovery, more pronounced cognitive deficits, and lower quality of life than is stroke without depression (4). For this reason, it is clinically relevant to have the knowledge on how to prevent and treat post-stroke depression.
Psychiatry Education Forum Academy has summarized this topic in the following three chapters:
Post Stroke Depression: Pathophysiology & Risk Factors
Post Stroke Depression: Treatment
Post Stroke Depression: Prevention
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