Nearly one in 12 American stroke survivors may have contemplated suicide or wished themselves dead, according to a study presented at the American Stroke Association's International Stroke Conference 2013.
The proportion of stroke survivors who contemplated suicide was striking, compared with patients with other health conditions, said Amytis Towfighi, M.D., lead author of the study and an assistant professor of Clinical Neurology at the University of Southern California in Los Angeles and chair of the Department of Neurology at Rancho Los Amigos National Rehabilitation Center.
In a nationally representative sample of the U.S. population, 7.8 percent of stroke survivors reported suicidal thoughts, compared to 6.2 percent of heart attack survivors, 5.2 percent of diabetes patients and 4.1 percent of cancer patients. "Given the high prevalence of suicidal thoughts among stroke survivors, perhaps regular screening for suicidal ideation, in addition to depression, is warranted," Towfighi said.
About 7 million U.S. adults have a history of stroke, according to American Stroke Association statistics. About one third of stroke survivors develop depression, but there is little data on suicidal thoughts, Towfighi said.
Researchers investigated how many stroke survivors had recent suicidal thoughts, as well as the characteristics of these patients using data from the National Health and Nutrition Examination Surveys (NHANES) conducted from 2005 to 2010. During that time, an estimated 6.2 million U.S. adults were stroke survivors.
NHANES is an ongoing series of elaborate, cross-sectional surveys providing a snapshot of Americans' health. This study focused on participants' responses to the following question: "Over the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way?"
Stroke survivors were more likely to have suicidal thoughts if they had a higher depression score, were younger, had higher body mass index, lower education level, lower poverty index, were single and were women.
Among the stroke survivors, 17 percent suffered from depression. Depression is the most common psychological complication after stroke. "Post-stroke depression can be associated with poorer functional outcomes, worse quality of life, higher mortality, low psychological well-being, suicidal ideation and suicide," Towfighi said.
The researchers haven't calculated what percentage of all NHANES participants, stroke survivors or not, might be suicidal. But Towfighi cited previous studies which found an annual suicide rate that was nearly double the expected figure for the population as a whole.
The cross-sectional design of the study didn't allow researchers to determine cause-and-effect relationships between stroke and suicidal thoughts. Additionally, the NHANES data didn't include information about how recently people's strokes had occurred, or whether the strokes were due to a ruptured blood vessel (hemorrhagic stroke) or a blocked blood vessel in the brain (ischemic stroke). The study also didn't account for patients' varying levels of disability.
Co-authors are Daniela Markovic, M.S., and Bruce Ovbiagele, M.D., M.Sc., M.A.S. Author disclosures are on the abstract.
Follow news from the ASA International Stroke Conference 2013 via Twitter @HeartNews; #ISC13.
To reach a suicide crisis center in your area call -800-273-TALK or visit hopeline.com. Learn more about life after stroke.
Statements and conclusions of study authors that are presented at American Stroke Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty 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 device corporations are available at www.heart.org/corporatefunding.
Note: Actual presentation of this moderated poster is 4:20 pm HT, Thursday, Feb. 7, 2013.
All downloadable video/audio interviews, B-roll, animation and images related to this news release are located on the right column of the release link. Video clips with researchers/authors of studies will be added to the release links after embargo.