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http://www.beloitdailynews.com/article/20180110/AP/301109925
By AMERICAN HEART ASSOCIATION NEWS
Strokes can be disabling, leaving survivors to confront many
challenges during their recovery. Now, a new Asian study shows survivors
are at higher risk for attempting suicide, especially if they are
younger, less affluent and have a physically demanding job.
Researchers analyzed data from more than 2 million people in Taiwan
between 2000 and 2010. They found that by the end of 2011, stroke
patients were more than twice as likely to have attempted suicide as
people who had not had a stroke.
The findings, published Wednesday in the Journal of the American
Heart Association, mirror results of similar studies on Western
populations.
The new study is significant because it is one of the few that
focuses on the connection between stroke and suicide attempts in Asia,
according to neurologist Dr. Bruce Ovbiagele, professor and chairman of
neurology at the Medical University of South Carolina, who was not
involved in the study.
The study found that 1,925 people — or 0.13 percent — of the more
than 1.4 million Taiwanese who didn’t have a stroke attempted suicide.
That compared to suicide attempts among 2,140, or 0.3 percent, of
713,690 stroke patients.
Ovbiagele noted, however, that one of the study’s weaknesses is that it doesn’t discuss the severity of the strokes.
Among stroke patients overall, suicide attempts were more common
among people who had their stroke before age 50, manual laborers and
those earning a low income.
The high cost of recovering from a stroke may explain why low-income
workers would be more likely to attempt suicide, according to the
study.
“Health-related rehabilitation services are often insufficiently
funded and provided in many respects, particularly in Asian and
developing societies,” the researchers wrote.
Ovbiagele said many stroke patients have lingering physical or
psychological effects, which might especially depress a manual laborer
who couldn’t continue to work or a younger person facing a lifetime of
limitations.
Doctors also aren’t sure whether the stroke itself sets off a
physical reaction that can lead patients to become depressed or
suicidal.
“The biological mechanism by which individuals with stroke become
more prone to depression and suicidal ideation is unclear, but likely
involves changes in neurotransmitters, cortisol levels and cerebral
blood flow,” said Dr. Amytis Towfighi, a vascular neurologist at the
University of Southern California’s Keck School of Medicine.
“Post-stroke depression is complex and likely involves a combination
of biological and psychosocial factors,” said Towfighi, who chaired a
committee that wrote last year’s scientific statement from the American
Heart Association about depression after stroke. She was not involved in
the new study.
Regardless of the factors at play, post-stroke depression is vastly
underdiagnosed, said Ovbiagele, who also coauthored the AHA statement
and is chair of the American Stroke Association’s International Stroke
Conference 2018 program committee.
“The patient or caregiver often has to complain about it or the
doctor has to routinely look out for it,” he said. “Since a substantial
number of stroke patients subsequently develop depression, ideally this
would be an important issue for clinicians to think of and address in
appropriate patients after a stroke.”
If you have questions or comments about this story, please email editor@heart.org.
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