Aug 2026· Clinical neurology and neurosurgery (Dutch-Flemish ed. Print)· Vol 271, pp.
109619
· 0 citations· 26 references
Medicine
TL;DR
A history of stroke was found to significantly increase the odds of suicidal ideation in those with depression, and these findings can help inform better integrative screening and treatment of mental health among stroke patients, especially those with co-morbid depression.
Abstract
Objective
Stroke patients often have mental health comorbidities such as depression and suicidal ideation. Stroke is a leading cause of long-term disability and is associated with increased risk of death, with mental illness playing a large role in this relationship. However, the impact of stroke on suicidal ideation among individuals with co-morbid depression is not well understood. We aim to determine if stroke in combination with depression was associated with a higher prevalence and severity of suicidal ideation.
Methods
We performed a retrospective cross-sectional study using data from the National Health and Nutrition Examination Survey, 2011-2018. All respondents were divided into four mutually exclusive categories based on their diagnosis of stroke and depression. Weighted prevalence estimates and 95% confidence intervals (CI) were reported across clinical and demographic categories. Multivariable logistic regression models were used to identify the independent association between stroke, depression, and suicidal ideation. Adjusted odds ratios (AOR) and a p-value of < 0.05 were used to determine statistical significance.
Results
The analytic sample included 19,397 participants, of whom 863 (4%) had a history of stroke. Depression was present in 154 (0.7%) participants with stroke and 2709 (11.6%) participants without stroke. The mean age of participants with stroke and depression was 59 years. This group was more likely to be female (64%), non-Hispanic White (67.7%), have more than a high school education (38.9%), and be overrepresented among those living at or below the federal poverty level (69.8%). Stroke was independently associated with an increased risk of suicidal ideation in those with depression (adjusted odds ratio [AOR] = 1.86; 95% CI: 1.21-2.85; p = 0.005) when compared to those with depression but without stroke. Living at or below the poverty level was also independently associated with increased suicidality risk (AOR = 1.39; 95% CI: 1.11-1.74; p = 0.005).
Conclusion
A history of stroke was found to significantly increase the odds of suicidal ideation in those with depression. These findings can help inform better integrative screening and treatment of mental health among stroke patients, especially those with co-morbid depression.
Depression has been associated with cardiovascular disorders, including stroke. Although, the graded association and the role of antidepressant medication use continue to be uncertain. To examine the link between depression severity (PHQ-9) and stroke, comprising nonlinear effects and interaction with the use of antidepressant. In this study, data was analysed from NHANES 2007–2018 (n = 35,162), of whom 32,040 participants with complete data were incorporated in the final analysis. Severity of depression was evaluated by using PHQ-9. Self-reported prevalent stroke was the outcome. Odds ratios (ORs) were estimated by survey weighted logistic regression models. Nonlinear associations were evaluated by using natural cubic splines. Greater PHQ-9 scores were significantly linked with augmented odds of self-reported stroke (OR 1.07, 95% CI 1.05–1.09, p < 0.001). Use of antidepressant was independently linked with self-reported stroke (OR 1.74, 95% CI 1.27–2.39). No statistically significant interaction was observed between PHQ-9 score and antidepressant use (p = 0.061). Natural cubic spline analysis demonstrated a significant overall association between PHQ-9 score and self-reported stroke, with no statistically significant evidence of nonlinearity. Both hypertension and diabetes were strong independent predictors of self-reported stroke, while higher income (PIR) was protective. Severity of depression was independently associated with higher odds of self-reported stroke. These findings highlight an association between depression severity and self-reported stroke history.
Unknown authors· Discover Public Health· 0 citations
HEI-2020 was inversely associated with PSD, with nonlinear and race-specific patterns and DI-GM showed a significant but inconsistent indirect association, suggesting a suppressive rather than mediating role.
Can Xing, Zhenhui Lu, Xiaoming Guo et al.· BMC Psychiatry· 0 citations
This study suggests that national patterns support embedding behavioral health screening, smoking and substance use cessation into standard stroke rehabilitation, with prioritization of female, Medicaid-insured survivors, and those without partners, and ensuring continuity during public health crises.
Chris-Mike Agbelie, Zahra Mojtahedi, Tanya H Lee et al.· Topics in Stroke Rehabilitat...· 0 citations
BACKGROUND
Type 2 diabetes (T2D) is a chronic metabolic disease linked to mental health issues, including suicidal ideation. Despite growing concern, limited research has explored the sex-specific biological and psychosocial risk factors contributing to suicidal ideation in this population.
OBJECTIVE
We sought to identify sex-specific factors associated with suicidal ideation in individuals with type 2 diabetes.
METHODS
A cross-sectional study was conducted with 695 adults diagnosed with T2D at a university hospital outpatient clinic between May 2022 and April 2023. Clinical and laboratory data were obtained from electronic health records. Suicidal ideation and fatigue were assessed using self-reported questionnaires. Multiple logistic regression was performed using SPSS 30.0 to identify sex-specific factors.
RESULTS
Among the 695 participants, the mean age was 60.5 (SD = 11.8), and 406 (58.4%) were men. In men, being married (adjusted odds ratio [AOR] = 4.54) and reporting higher fatigue (AOR = 1.44) were associated with suicidal ideation, while living with someone was associated with lower suicidal ideation (AOR = 0.16). In women, elevated creatinine (AOR = 11.69), smoking (AOR = 10.84), and higher fatigue (AOR = 1.43) were significantly associated with suicidal ideation.
CONCLUSION
Marriage is significantly associated with suicidal ideation, while living with someone protects from suicidal ideation in men. Elevated creatinine and smoking are associated with higher suicidal ideation in women. Fatigue emerged as a consistently associated factor of suicidal ideation. The findings highlight the need for tailored suicide risk screening and for interpreting the influence of social support by gender. Fatigue management is crucial for the prevention of suicide among individuals with T2D.
Jieun Lee, S. Hwang, Hyon-Seung Yi et al.· Western Journal of Nursing R...· 0 citations
BACKGROUND
Limited population-based analyses of associations of comorbid depression and diabetes have tested metabolic risk factors as mediating variables for the association between depression and clinical outcomes.
METHODOLOGY
We included Chinese adults with type 2 diabetes attending structured diabetes risk assessment in Hong Kong between 1 January 2000 and 30 June 2024. Depression was identified using International Classification of Disease-9 codes or prescription of anti-depressants. People with baseline cardiovascular disease or end-stage kidney disease (ESKD) were excluded. We estimated the hazard ratio (HR) of cardiovascular diseases, ESKD, all-cause death associated with depression compared to those without depression. We examined the mediating effects of eight cardiometabolic risk factors in these risk associations.
RESULTS
Among 571,129 people with type 2 diabetes, 7.5% had depression (mean age 60.4 years, 66.1% women, mean HbA1c 7.2%). People with depression had greater number of all-cause hospitalisation and longer length of stay. Compared to no depression, depression was associated with higher hazards for incident cardiovascular disease (HR: 1.21 [1.17, 1.24]), all-cause death (HR: 1.30 [1.26, 1.33]), but not ESKD (HR 0.95 [0.89, 1.01]), adjusted for age, sex and diabetes duration. Mediation analyses revealed the association between depression, cardiovascular disease and all-cause death were mediated predominantly by the direct effect of depression.
CONCLUSION
Depression is associated with greater risks for incident cardiovascular disease and all-cause death in people with type 2 diabetes. Mediation analyses revealed minor contributions from metabolic risk factors on these associations, highlighting the need for enhanced screening for depression and integrated care.
E. W. Chow, E. Lau, Hongjiang Wu et al.· Journal of Affective Disorde...· 0 citations
Physical conditions are increasingly recognized as contributors to suicide risk, independent of psychiatric comorbidity. The aim of this study was to descriptively examine the association between a range of lifetime physical conditions and suicide attempts in a large, population-based US sample. Data were analyzed from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; N = 36,171). Lifetime suicide attempts (n = 1995) were assessed via self-report. Physical conditions were self-reported based on physician diagnosis and included a range of metabolic, infectious, cardiovascular, gastrointestinal, neurological, respiratory, and autoimmune diseases. Over 20% of those with arteriosclerosis and hypertension, arthritis, and dyslipidemia, sleep problems, and cardiovascular disease (20.1-27.9%) endorsed a lifetime suicide attempt. With the exception of cancer, all physical conditions were associated with suicide attempts. After adjustment for sociodemographic factors and psychiatric conditions, most associations were attenuated but remained significant (adjusted odds ratio [AOR] range across the significant conditions: 1.16-2.75), with the strongest associations observed for epilepsy and HIV/STIs. Only cancer, osteoporosis, and traumatic brain injury were not significantly associated with suicide attempts in the fully adjusted models. Increasing number of health conditions was also significantly associated with suicide attempts across all models. Findings may inform suicide prevention efforts by highlighting the need for integrated physical and mental health care, particularly for patients living with multimorbidity. Results were correlational and future research should examine relationships longitudinally.
Joanna Bhaskaran, J. Sommer, N. Mota et al.· Journal of Psychosomatic Res...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
