Stroke survivors more likely to attempt or die by suicide

Reviewed by Emily Henderson, B.Sc.Mar 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.

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. 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."

Manav V. Vyas, M.B.B.S., M.Sc., Study Author and Clinical Associate, Neurology, University of Toronto, Canada

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."