Predictors of suicidal ideation among acute stroke survivors

Aim The risk of suicide in patients with stroke is high compared to the general population. To identify specific subgroups at higher risk of suicide in the early post-stroke period, we examined the relationship between the acute stroke-related clinical variables, patient demographics, depression, and suicidal ideation (SI). Methods We reviewed prospectively collected data from the comprehensive stroke center with patients who had an ischemic or hemorrhagic stroke and screened for depression with the Patient Health Questionnaire 9-Item (PHQ-9) at 90 days post-stroke outpatient follow-up. Question 9 of the PHQ-9 was screened for the presence of SI. Results A total of 6.7% of patients reported SI. There were significant differences between groups among patients who reported SI as compared to those without SI with respect to ischemic stroke (p = 0.026), longer hospital stay (p = 0.009), and higher disability modified Rankin scale score at seven days post-stroke (p = 0.014). Limitations We did not have access to the number of stroke survivors with SI who attempted suicide. Discussion Our results show that screening based on PHQ-9 can identify the stroke survivors at risk for suicide and then enable additional risk assessment and stratify the patient to appropriate mental health support, thus reducing suicide, a preventable condition.