"The study shows the need of both psychological and social support, as well as concrete measures to prevent suicide attempts, in people who have had a stroke and are at high risk of attempted suicide. The initiatives must also be put in place at an early stage as the risk of attempted suicide is greatest up to two years after a stroke," says Marie Eriksson, senior lecturer at the Department of Public Health and Clinical Medicine and senior lecturer in Statistics at the Umeå School of Business and Economics, Umeå University, who conducted the study.
The study encompasses 220 336 patients who had a stroke during the period 2001-2012 and was registered in Riksstroke, the Swedish Stroke Register. Stroke patients that had attempted suicide were identified via the diagnostic code for attempted suicide found in the National Inpatient Register (National Board of Health and Welfare), and completed suicides were found by the researchers in the national Cause of Death register.
During the follow-up period, 1 217 suicide attempts were registered in the patient group, 260 of which died as a result of the attempt.
According to the study, the incidence of suicide among those who have had a stroke is double that of the rest of the population, and among patients under 55 years of age, the risk increase is fivefold. Patients with a low level of education or income had a 37 percent higher risk of attempting suicide compared with those with a university education, whereas the corresponding figure for patients who lived alone was 72 percent. Patients born outside of Europe, on the other hand, ran half the risk of committing suicide compared with people born in Europe; something which, based on other studies, could possibly be accounted for by protective cultural and religious factors.
Other risk factors for suicide attempts which Marie Eriksson and her colleagues can demonstrate in the study are male sex, strokes with severe consequences, and post-stroke depression. The study also shows that the risk of attempted suicide was highest during the first two years after a stroke.
"There is a clear risk that signs of mental illness and the risk of suicide attempts among people who have suffered a stroke is underestimated in health care services. In this study, we can clarify some of the risk factors for suicide attempts among people who have suffered a stroke. With in-depth knowledge of this vulnerable patient group, there is also potential for identification of the patients who are at higher risk of attempting suicide and even deploying preventive measures," explains Eva-Lotta Glader, medical doctor and researcher at the Department of Public Health and Clinical Medicine, and one of the co-authors of the study.