Methods:
Using
a comparative cross-sectional design, we consecutively recruited 130
stroke survivors attending rehabilitation in a large university
hospital. Also included were 130 age-, sex-, and education-matched
caregivers who were unrelated to stroke survivors. Along with clinical
and historical details, cognitive functions, experience of serious
suicidal thoughts, and major depressive disorder (MDD) were
independently assessed using validated semi-structured interviews.
Results:
Serious
suicidal thoughts were present in 20 (15.4%) stroke survivors and 19
(14.6%) controls. Poststroke suicidal thoughts occurred in the contexts
of MDD (
P < .001), marital separation (
P = .019), and cognitive dysfunction (
P
= .037). In a multivariate logistic regression model including age,
gender, MDD, marital separation, and cognitive dysfunction as
covariates, poststroke MDD and marital separation led to 5.6-fold (95%
confidence interval [CI]: 3.5-21.0) and 4-fold (95% CI: 1.2-14.0)
increases, respectively, in the odds of serious suicidal thoughts.
Conclusions:
Serious
suicidal thoughts after stroke in this African sample were more common
than the reported average prevalence in the global literature.
Poststroke major depression was the key reversible risk factor for
suicidal thoughts. Depression is treatable and prompt treatment may
prevent suicidal deaths and reduce the burden of stroke in black
Africans.
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