Suicide risk elevated among stroke survivors
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Stroke survivors may be more likely to attempt or die by suicide than people who have not had a stroke, according to a meta-analysis presented at the American Stroke Association’s virtual International Stroke Conference.
Developing strategies for screening and treatment of depression and suicidal ideation in stroke survivors can help reduce the overall suicide risk in this population, according to the researchers.
“Potential reasons why stroke survivors may be at a higher risk of suicide include physical, cognitive and mental health consequences of the stroke. Much like many other chronic conditions, stroke survivors may feel depressed and have suicidal thoughts, putting them at a higher risk of suicide,” Manav V. Vyas, MBBS, MSc, clinical associate in neurology at the University of Toronto, told Healio.
To determine the association between stroke and suicide, researchers analyzed 23 studies that included more than 2 million stroke survivors (mean age, 64 years; 52% women), of whom 5,563 attempted suicide or died by suicide. The findings were simultaneously published in Stroke.
The researchers found stroke survivors had higher risk for suicide compared with the nonstroke group (pooled adjusted RR = 1.73; 95% CI, 1.53-1.96; I2= 93.5%).
In a comparison of suicide outcomes, the researchers found the risk difference between the stroke and nonstroke groups was greater for suicide attempt (aRR = 2.11; 95% CI, 1.73-2.56) than for death by suicide (aRR = 1.61; 95% CI, 1.41-1.84; P for interaction = .03).
The risk difference lessened the longer patients were followed in a study (RR per 1-year increase in follow-up = 0.97; 95% CI, 0.95-0.99), the researchers found.
Vyas told Healio that future research “should evaluate the risk factors associated with a higher risk of suicide among stroke survivors. Furthermore, prospective evaluation of the timing of suicide following stroke can be useful to determine the high-risk period following stroke, and to develop targeted screening and treatment.
“Many stroke survivors may not be able to communicate how they feel because of language deficits following stroke, and so it is important to evaluate their mood. Both families of stroke survivors and their health care providers can play an important role in identifying at-risk stroke survivors,” Vyas told Healio.
Reference:
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Vyas MV, et al. Presentation P237. Presented at: International Stroke Conference; March 17-19, 2021 (virtual meeting).
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