Key result
Depression linked to ~28% greater risk of haemorrhagic stroke.
Why the study?
Strong evidence on haemorrhagic stroke risk in patients with psychiatric conditions was needed to inform future studies and potentially lead to more effective interventions.
Does the presence of psychiatric disorders increase the risk of haemorrhagic stroke compared to patients without these disorders?
Meta-Analysis
Does the presence of psychiatric disorders increase the risk of haemorrhagic stroke compared to patients without these disorders?
Patients with depression have a significantly increased risk of haemorrhagic stroke, highlighting the need for comprehensive cardiovascular risk management in this population.
Answers are grounded in this paper and cite their sources.
Depression may warrant closer haemorrhagic stroke surveillance; leaves open whether intervention alters risk in observational data.
OBJECTIVES: Strong evidence on the risk of haemorrhagic strokes for those with psychiatric conditions may lead to more effective interventions for mental health patients and inform future studies. This systematic review aimed to identify all the studies that compare the risk of haemorrhagic stroke for patients with and without depression, anxiety, schizophrenia, bipolar or personality disorders. It also aimed to provide a summary estimate of the risk, where possible, using meta-analysis. METHODS: Electronic searches were conducted in Embase, PsycINFO, PubMED, Scopus and the Web of Science, from database inception to the 11th of March 2025. A Random-effects model to estimate the pooled effect size with 95% confidence intervals was used. RESULTS: 17,214 references were initially identified. Eleven articles were included. Seven of them, five observational and two mendelian randomisation studies, investigated depression. In the meta-analysis depression showed a significant association with an increased risk of haemorrhagic stroke, with pooled HR: 1.28 (1.19-1.38) when only observational studies were included. When mendelian randomisation studies were added the result was a pooled HR: 1.26 (1.08-1.44). The risk of haemorrhagic stroke was increased in one of the three studies that investigated patients with anxiety disorders and in one of the three that looked at patients with schizophrenia. Two studies of bipolar disorder, and one of personality disorders, reported that patients with these conditions do not have an increased risk of haemorrhagic stroke. CONCLUSION: Patients with depression have an increased risk of haemorrhagic stroke. The association of mental illness with haemorrhagic stroke needs further research.
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Ayerbe et al. (2025) conducted a meta-analysis in Psychiatric disorders. Depression vs. No depression was evaluated on Risk of haemorrhagic stroke (HR 1.28, 95% CI 1.19-1.38). Depression significantly increased the risk of haemorrhagic stroke by 28% (HR 1.28) compared to patients without depression in a meta-analysis of observational studies.
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