Abstract 115: Predictors Of Post-stroke Depression And Suicidal Ideation Among Acute Stroke Survivors

Abstract

Introduction: Approximately a third of stroke survivors are diagnosed with Post-Stroke Depression (PSD) and half are more likely to commit suicide compared to the general population. The aim of this study was to examine the relationship between demographic and clinical variables and PSD and suicidal ideation among post-stroke survivors. Methods: This was a retrospective review of a clinical registry from a comprehensive stroke center between 10/2018 and 3/2020. Patients were eligible if a Patient Health Questionnaire 9-Item (PHQ-9) was available. Question 9 of the PHQ-9 was screened for suicidal ideation. Results: The study cohort consisted of a total of 194 patients who had an acute (primarily ischemic or intracerebral) stroke who completed a 90-day telephonic PHQ-9. The mean age (years) and NIH Stroke Scale were 64 ± 15 and 7.4 ± 7.3, respectively. The sample was comprised of 56% men, 39% Whites, 31% Blacks, 27% Asians, and 10% Hispanics. The mean PHQ-9 score was 5.9 ± 6.3. Seven percent reported suicidal ideation. Univariate analysis revealed that pre-stroke depression history and 90-day post-dicharge mRS scores were significantly associated with PHQ-9 scores (p=0.005 and p=0.003, respectively). After adjusting for age, stroke type, NIHSS arrival score, pre-morbid mRS score, mRS score at 7 days, and hospital length of stay, multiple linear regression analysis with bootstrap estimates found that pre-stroke depression and 90-day post-dicharge mRS scores remained significant (p<0.001 and p=.004, respectively; see Table 1). Although both days 7 (p=0.014) and 90 (p=0.049) mRS scores were found to be significantly different than those with and without suicidal ideation, the effect size in patients with suicidal ideation was larger for day 90 (d=.66) than for day 7 (d=.36) mRS scores. Conclusion: Patients with a history of depression and those with higher mRS scores at 90 days should be screened for suicidal ideation and actively managed for depression.