Premium
Poststroke suicide risk among older adults in South Korea: A retrospective longitudinal cohort study
Author(s) -
Choi Jae Woo,
Lee Sang Gyu,
Kim Tae Hyun,
Han Euna
Publication year - 2020
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5245
Subject(s) - hazard ratio , medicine , depression (economics) , stroke (engine) , cohort , proportional hazards model , comorbidity , cohort study , poison control , confidence interval , retrospective cohort study , psychiatry , physical therapy , emergency medicine , mechanical engineering , engineering , economics , macroeconomics
Objectives The present study evaluated suicide risk within 1 year after discharge among older adults with stroke as a function of depression onset. Method We used the Korean National Health Insurance Service‐Senior cohort data and included first discharged patients with a stroke as the principal diagnosis. The comparison group was selected by a 1:2 case‐control propensity score matching for age, sex, Charlson comorbidity index, and diagnosis year between 2005 and 2012. Suicide deaths were measured by code for causes of death from Statistics Korea, and the main outcome was suicide death within 1 year following discharge. An adjusted hazard ratio (AHR) of suicidal risk was measured using a Cox proportional hazard model. Results In the total sample of 128 286 older adults (aged 63‐114 years), the higher suicidal risk was examined for stroke patients vs the comparison group (AHR = 1.4; 95% confidence interval [CI], 1.1‐1.8). Stroke patients with depression had an increased suicide risk (AHR = 2.9; 95% CI, 1.8‐4.8) but only for poststroke depression (AHR = 4.1; 95% CI, 1.8‐9.5). Pre and poststroke depression suicidality (AHR = 4.8; 95% CI, 2.1‐11.1) was also higher when compared to stroke patients without depression. Conclusions Poststroke patients are at increased suicidal risk during 1 year following discharge. Furthermore, patients who were diagnosed with depression after a stroke are more likely to commit suicide than stroke patients without depression. This suggests a necessity for early suicide preventive intervention for stroke patients while considering depressive symptomology.