Predictors of suicidal ideation among acute stroke survivors

Abstract

Aim: The risk of suicide in patients with stroke is high compared to the general population. To identify specific subgroups at higher risk of suicide in the early post-stroke period, we examined the relationship between the acute stroke-related clinical variables, patient demographics, depression, and suicidal ideation (SI). Methods: We reviewed prospectively collected data from the comprehensive stroke center with patients who had an ischemic or hemorrhagic stroke and screened for depression with the Patient Health Questionnaire 9-Item (PHQ-9) at 90 days post-stroke outpatient follow-up. Question 9 of the PHQ-9 was screened for the presence of SI. Results: A total of 6.7% of patients reported SI. There were significant differences between groups among patients who reported SI as compared to those without SI with respect to ischemic stroke (p = 0.026), longer hospital stay (p = 0.009), and higher disability modified Rankin scale score at seven days post-stroke (p = 0.014). Limitations: We did not have access to the number of stroke survivors with SI who attempted suicide. Discussion: Our results show that screening based on PHQ-9 can identify the stroke survivors at risk for suicide and then enable additional risk assessment and stratify the patient to appropriate mental health support, thus reducing suicide, a preventable condition.