Is fatigue associated with suicidality in stroke?

Objective: To evaluate the relationship between poststroke fatigue and suicidality (SI) in Chinese patients with first or recurrent stroke.

Design: Cross-sectional survey.

Setting: Acute stroke unit of a general hospital.

Participants: Patients with acute ischemic stroke (N=595) admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong.

Interventions: Not applicable.

Main outcome measures: SI was assessed with the Geriatric Mental State Examination at 3 months after the subjects' index stroke. Fatigue was evaluated using the Fatigue Severity Scale (FSS). The association between the mean FSS score and SI was examined and adjusted for potential confounders, including age, sex, marital status, previous stroke, depression, Mini-Mental State Examination score, and neurologic deficits in terms of the National Institutes of Health Stroke Scale score.

Results: Seventy-six (12.8%) of the patients had SI (the SI group). The FSS score was significantly higher in the SI group (4.0±1.4 vs 2.8±1.2). The FSS score remained a significant predictor of SI in the subsequent forward logistic regression (odds ratio=1.5), adjusting for the possible confounders.

Conclusions: These findings should alert clinicians that early identification and treatment of fatigue may reduce the suicidal risk in stroke patients.