Stroke survivors may have higher suicide risk

DALLAS, March 11, 2021– Stroke survivors may be more likely to attempt or die by suicide than people who have not had a stroke, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2021. The virtual meeting is March 17-19, 2021 and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health. This study will be simultaneously published in the American Heart Association’s journal

Stroke

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Rates of depression among stroke survivors range from 28% to 35%, and stroke is considered an independent risk factor for depression. Since depression after a stroke has been associated with increased suicidal thoughts, researchers sought to quantify and understand the risk of suicide after stroke.

“Recognizing that stroke may increase the risk of suicidal thoughts or suicide attempts will help stroke survivors, their families and health care professionals to identify and hopefully reduce these risks,” said study author Manav V. Vyas, M.B.B.S., M.Sc., clinical associate in neurology at the University of Toronto in Canada. “It is important we investigate this issue because nearly 15 million people worldwide have a stroke each year, of which approximately 10 million survive. Stroke survivors have physical and mental health consequences and may be more likely to attempt suicide or die by suicide.”

Researchers searched multiple international medical databases including MEDLINE, Embase, PsycINFO and Google Scholar from the inception of each database to September 15, 2020 using keywords and database-specific subject headings for stroke and suicide. They analyzed 23 published studies that included more than 2 million stroke survivors to examine the association between stroke and suicide. More than 5,500 of those survivors attempted suicide or died by suicide.

When researchers compared their analysis to suicide statistics among the general population, they found stroke survivors:

• had a 73% higher risk of suicide;
• were more than twice as likely to attempt suicide;
• had a 63% higher risk of dying by suicide; and
• had a diminished risk of suicide with time.

“We anticipated that the risk of suicide in stroke survivors would be high, but we were surprised that it was 73% higher,” Vyas said. “I hope that this study highlights the need to recognize the scale and impact of disability in stroke survivors and their potential influence on mental health status. Having a conversation about low mood or depressed feelings can be challenging for stroke survivors who are often unable to communicate due to the stroke, therefore, health care professionals should consider routine screening of all stroke patients for symptoms of depression and suicidal thoughts, among other mental health conditions.”

This study has a few limitations, including that it is observational and cannot conclude that stroke causes suicide. Another limitation is that some of the studies examined did not exclude people who had a history of attempted suicide prior to the stroke, which could have impacted the results.

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Study co-authors are Jeffrey Z. Wang, M.D.; Meah M. Gao, M.D.; and Daniel G. Hackam, M.D., Ph.D. The authors’ disclosures are listed in the abstract. They reported no external funding sources for this study.

Additional Resources:

Are you in a crisis? Please call the National Suicide Prevention Lifeline at 800-273-8255. Or contact the Crisis Text Line by texting TALK to 741741. Additional resources available from the American Foundation for Suicide Prevention.

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Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association’s overall financial information is available here.

The American Stroke Association’s International Stroke Conference (ISC) is the world’s premier meeting dedicated to the science and treatment of cerebrovascular disease. ISC 2021 will be held virtually, March 17-19, 2021. The 3-day conference features more than 1,200 compelling presentations in 21 categories that emphasize basic, clinical and translational sciences as they evolve toward a better understanding of stroke pathophysiology with the goal of developing more effective therapies. Engage in the International Stroke Conference on social media via #ISC21.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit

stroke.org

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