Factors associated with post-stroke suicidal death

Abstract

Background and purpose: The aim of this study was to estimate the relative risk of suicidal death compared to the general population and to identify risk factors for suicidal death among stroke patients. Methods: Our sample consisted of 7175 patients who were diagnosed with stroke and admitted at Asan Medical Center from January 2005 to December 2012. Information on suicidal death was obtained from the database of the Korean National Statistical Office. The standardized mortality ratio (SMR) for post-stroke suicide was estimated. Additionally, we conducted a 1:6 case-control study using patients who did not commit suicide. Results: Thirty patients committed suicidal death, with the mean time interval between hospital admission and suicide being 1.9 1.8 years. The SMR for suicide was 2.14 (95% confidence interval [CI], 1.44-3.05). Case control analysis revealed that diabetes mellitus, depression, and large ischemic lesions in the subcortex and brainstem were significantly associated with suicidal death. Conclusions: The risk of suicidal death is approximately 2 times higher than that in the general population. Depression, diabetes, and large lesions in specific locations should be considered in the implementation of suicide prevention strategies in stroke patients.