The association between depression, suicidal ideation, and stroke in a population-based sample

Background Stroke survivors often experience poststroke depression and suicidal ideation. Purpose to determine the frequency and odds ratio of depression and suicidal ideation among stroke survivors, in comparison to those without stroke, and to identify demographic factors associated with elevated odds of depression and suicidal ideation among stroke survivors. Methods Secondary analysis of the Canadian Community Health Survey, a population-based sample. Logistic regressions of depression and suicidal ideation were conducted. Results Among those with stroke, 7.4% were depressed, in comparison to 5.2% of those without stroke (P = 0.01). The cumulative lifetime frequency of suicidal ideation was 15.2% among stroke survivors in comparison to 9.4% of those without stroke (P < 0.001). After adjusting for sociodemographic factors, stroke survivors had twice the odds of depression and suicidal ideation in comparison to those without stroke (odds ratio = 2.21; 95% confidence interval = 1.61, 3.04 and odds ratio = 2.07; 95% confidence interval = 1.68, 2.55, respectively). When functional limitations and activities of daily living limitations were added to the analyses, there was a substantial decrease in the associations between stroke and depression (odds ratio = 1.29; confidence interval = 0.93, 1.80) and between stroke and suicidal ideation (odds ratio = 1.37; 95% confidence interval = 1.10, 1.69). Caucasians and younger individuals had higher odds of poststroke depression and suicidal ideation. Stroke survivors with functional limitations had much higher odds of suicidal ideation than those without such limitations. Conclusions Regular screening for depression and suicidal ideation is important for stroke survivors, particularly those with substantial physical limitations.