Associations between DSM-IV mental disorders and subsequent non-fatal, self-reported stroke

Area of Science:

• Epidemiology
• Psychiatry
• Neurology

Background:

• Mental disorders are prevalent global health issues.
• Stroke is a leading cause of disability and mortality worldwide.
• Understanding the interplay between mental health and cerebrovascular disease is crucial for public health.

Purpose of the Study:

• To investigate the association between a broad spectrum of mental disorders and the subsequent risk of stroke.
• To explore the influence of mental disorder onset timing on stroke incidence.

Main Methods:

• Utilized data from the World Mental Health Surveys, encompassing 87,250 adults across 17 countries.
• Employed the Composite International Diagnostic Interview for retrospective assessment of lifetime mental disorders.
• Applied survival analyses to a weighted subsample (n=45,288) to determine associations between mental disorders and stroke onset.

Main Results:

• Initially, 12 out of 16 assessed mental disorders showed a significant association with stroke.
• After adjusting for comorbidities and smoking, only depression (OR 1.3) and alcohol abuse (OR 1.5) remained significantly linked to stroke.
• Increased number of mental disorders correlated with stroke risk in a dose-response manner (OR 3.3 for 5+ disorders).
• Bipolar disorder was associated with higher stroke incidence in females (OR 2.1).

Conclusions:

• Depression and alcohol abuse may be specifically associated with non-fatal stroke incidence.
• The general severity of psychopathology appears to be a significant predictor of non-fatal stroke.
• Integrating mental health care into stroke risk prevention strategies is recommended.
• Further research is needed due to the limitations of retrospective cross-sectional survey designs.