Key result
Psychiatric disorders including depression are linked to ~50% higher stroke risk.
Why the study?
Psychiatric disorders may be associated with an elevated risk of stroke, but whether variations exist in this association across different populations remains controversial.
Do psychiatric disorders (depression, schizophrenia, bipolar disorder) increase the risk of stroke in individuals without prior stroke?
Meta-Analysis (n=25,519,635)
Do psychiatric disorders (depression, schizophrenia, bipolar disorder) increase the risk of stroke in individuals without prior stroke?
Psychiatric disorders, including depression, schizophrenia, and bipolar disorder, are significantly associated with an elevated risk of stroke, highlighting the need for enhanced monitoring and prevention in this population.
May warrant closer stroke surveillance in psychiatric patients; supports the association but leaves causality and preventive interventions open.
Background Psychiatric disorders may be associated with an elevated risk of stroke; however, the existence of variations in this association between different populations remains controversial. Consequently, we conducted a comprehensive systematic review and meta-analysis to examine the magnitude of the relationship between psychiatric disorders and the risk of stroke. Methods The PubMed, Embase, and Cochrane Library databases were systematically searched to identify eligible studies from inception to April 2024. The aggregated findings were expressed as relative risks (RRs) with 95% confidence intervals (CIs), and the combined analysis was performed using a random-effects modeling approach. Further exploratory analyses were also performed using sensitivity and subgroup analyses. Results A total of 36 cohort studies, involving 25,519,635 individuals, were selected for analysis. We noted that depression (RR: 1.50; 95% CI: 1.34–1.68; p < 0.001), schizophrenia (RR: 1.74; 95% CI: 1.36–2.24; p < 0.001), and bipolar disorder (RR: 1.65; 95% CI: 1.27–2.14; p < 0.001) were associated with an elevated risk of stroke. Further exploratory analyses found that the association between depression and the risk of stroke differed according to the adjusted level (RR ratio: 0.77; 95% CI: 0.61–0.98; p = 0.034), and the association between schizophrenia and the risk of stroke differed according to the outcome definition (RR ratio: 0.68; 95% CI: 0.52–0.90; p = 0.006). Moreover, the association between bipolar disorder and the risk of stroke differed according to the study design (RR ratio: 0.68; 95% CI: 0.55–0.84; p < 0.001). Conclusion The significant association between psychiatric disorders and an elevated risk of stroke highlights the importance of enhanced monitoring and stroke prevention in patients with psychiatric disorders. Systematic review registration Our study was registered on the INPLASY platform (number: INPLASY202450049).
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Hu et al. (2024) conducted a meta-analysis in Psychiatric disorders (depression, schizophrenia, bipolar disorder) (n=25,519,635). Depression vs. Individuals without psychiatric disorders was evaluated on Risk of stroke (RR 1.50, 95% CI 1.34-1.68, p=<0.001). Psychiatric disorders were significantly associated with an elevated risk of stroke, including depression (RR 1.50), schizophrenia (RR 1.74), and bipolar disorder (RR 1.65).
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