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Poststroke suicide risk among older adults in South Korea: A retrospective longitudinal cohort study

Authors
 Jae Woo Choi  ;  Sang Gyu Lee  ;  Tae Hyun Kim  ;  Euna Han 
Citation
 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol.35(3) : 282-289, 2020 
Journal Title
 INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY 
ISSN
 0885-6230 
Issue Date
2020
Keywords
depression ; older adults ; stroke ; suicide
Abstract
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.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1002/gps.5245
DOI
10.1002/gps.5245
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175534
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