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Is insomnia associated with suicidality in stroke?
Wai-Kwong Tang1, Jin-Yan Lu, Huajun Liang
1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. tangwk@cuhk.edu.hk
Objective:
To evaluate the relationship between insomnia 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 (N=787) with acute ischemic stroke admitted to the acute stroke unit of a university-affiliated regional hospital in Hong Kong.
Interventions:
Not applicable.
Main Outcome Measures:
Suicidality (SI) was assessed with the Geriatric Mental State Examination at 3 months after subjects' index stroke. Insomnia symptoms were evaluated with a standard insomnia questionnaire. The association between insomnia symptoms and SI was examined and adjusted for potential confounders, including age, sex, marital status, previous stroke, depression, fatigue, Mini-Mental State Examination score, and neurologic deficits measured with the National Institutes of Health Stroke Scale.
Results:
Eighty-seven patients (11.1%) were found to have SI (SI group). Frequent awakening was significantly more common in the SI group than in the non-SI group and remained a significant predictor of SI in forward logistic regression analysis (odds ratio, 1.7) after adjusting for possible confounders.
Conclusions:
These findings should alert clinicians to the potential danger of insomnia and the importance of its early identification and treatment in stroke patients.
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