Do Stroke Patients have an Increased Risk of Developing Suicidal Ideation or Dying by Suicide? An Overview of the Current Literature

• Type of Material: Article
• Authors: Maurizio Pompili, Sapienza University of Rome; Paola Venturini, Sapienza University of Rome; Sandra Campi, Sapienza University of Rome; Maria E. Seretti, Sapienza University of Rome; Franco Montebovi, Sapienza University of Rome; Dorian Lamis, Emory University; Gianluca Serafini, Sapienza University of Rome; Mario Amore, University of Parma; Paolo Girardi, Sapienza University of Rome
• Language: English
• Date: 2012-01-01
• Publisher: Wiley Open Access
• Publication Version: Final Published Version
• Copyright Statement: © 2012 Blackwell Publishing Ltd.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1755-5949.2012.00364.x
• Title of Journal or Parent Work: CNS Neuroscience and Therapeutics
• ISSN: 1755-5930
• Volume: 18
• Issue: 9
• Start Page: 711
• End Page: 721
• Keywords: BIPOLAR-DISORDER; Prevention; HYPERTENSION; Life Sciences & Biomedicine; METABOLIC SYNDROME; Intervention; SCHIZOPHRENIA; Poststroke depression; Stroke; Pharmacology & Pharmacy; ASSOCIATION; Neurosciences; PREVALENCE; POPULATION; MEDICAL ILLNESS; MAJOR DEPRESSION; Science & Technology; Suicide; Neurosciences & Neurology; DISEASE
• Research Categories: Biology, Neuroscience; Health Sciences, Pharmacology; Psychology, Clinical

Abstract

Stroke is a leading cause of death that affects 15 million people worldwide each year. Increasing evidence suggests that stroke confers substantial risk for suicide and following a stroke, patients frequently develop poststroke depression, which is a well-established risk factor for suicide. In this overview of the current literature, we examined the association between suffering a stroke and subsequent risk for suicide and suicidal ideation. We performed a careful MedLine, Excerpta Medica, PsycLit, PsycInfo, and Index Medicus search to identify all articles and book chapters in English. We initially selected 31 articles published between 1990 and 2011; however, only 16 studies were included in this review. All articles identified stroke as a significant risk factor for suicide, especially among depressed patients, providing further support for poststroke depression and suicidality. The results also indicated that there were differences between patients who developed acute-onset suicidal plans and those who reported delayed-onset plans, which occurred more frequently. Many of the stroke patients who died by suicide suffered from depression prior to their death, suggesting that being diagnosed with a mood disorder contributes to an increased risk of suicide in this population. Suffering from a stroke increases the risk of dying by suicide and developing suicidal ideation, particularly in young adults and women. The factors found to confer the most risk for suicidality were depression, previous mood disorder, prior history of stroke, and cognitive impairment.