Suicidal ideas in stroke patients 3 and 15 months after stroke

Patients with stroke may have an increased risk of suicide. We sought to ex amine the frequency and clinical correlates of suicidal ideas 3 and 15 mont hs after stroke. The study group comprised 286 of 486 consecutive patients aged 55-85 years who at 3 and 15 months after ischemic stroke completed a d etailed medical, neurological and radiological stroke evaluation, structure d measures of cognition (Mini Mental State Examination), emotion (Beck Depr ession Inventory, BDI), disability (Rankin scale), and assessment of depend ent living. Suicidal ideas were present in 9.8% (n = 28) at 3 months' follo w-up and in 14.0% (n = 40) at 15 months' follow-up. The patients with suici dal ideas were more depressed measured by BDI both at 3 (17.0 vs. 7.9, p < 0.001) and 15 months (20.5 vs. 8.5, p < 0.001) after stroke compared to the patients without suicidal ideas. Patients with suicidal ideas had more oft en a history of a stroke already before the index stroke (35 vs. 18.3%, p = 0.0154), right-sided stroke (60.0 vs. 41.9%, p = 0.0323), they were more d isabled according to the Rankin scale (2.4 vs. 1.9; p = 0.0035) and more de pendent in living (45.0 vs. 27.2%, p = 0.023) 15 months after stroke. An in dependent correlate of suicidal ideas 15 months after stroke was history of prior stroke (OR 2.4; 95% CI 1.14-4.97) in logistic regression analysis. T he frequency of suicidal ideas increased with the time elapsed from stroke. Recurrent strokes, depressive symptoms, more disabling stroke and right-si ded stroke correlated to suicidal ideas at 15 months after stroke. Early id entification of these risk factors may lead to effective therapeutic interv ention. Copyright (C) 2001 S. Karger AG. Basel.