Prevalence of suicidal ideation among stroke survivors: A systematic review and meta-analysis

ABSTRACT

Background: The prevalence of suicidal ideation (SI) among stroke survivors has been the subject of several studies, but systematic review data regarding the prevalence of SI among stroke patients are still scarce.

Objectives: To estimate the pooled prevalence of SI among stroke survivors.

Methods: A comprehensive search strategy was established across the following electronic databases; Web of Science, PubMed, the Cochrane Library, Chinese Wanfang database and Chinese National Knowledge Infrastructure (CNKI). The 95% confidence interval (CI) given in each identified study was used to assess the outcomes. Cochran’s Q test and I² statistic were used to evaluate heterogeneity. The quality of the final evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We calculated the pooled prevalence of SI among stroke survivors before subgroup analysis and meta-regression was used to find the partial source of heterogeneity.

Results: Twenty-one studies with a total of 17,189 participants were included in this study and the pooled prevalence of SI among stroke survivors was 12.25% (95%CI: 9.91–15.07%). Substantial heterogeneity was detected in the estimation of prevalence. The evidence was graded as very low for the overall outcome and the single item subgroup, while it was graded as low for the stable scale subgroup.

Conclusions: This meta-analysis suggests a high prevalence of SI among stroke survivors. Routine screening of SI after stroke is needed to plan interventions aimed at reducing suicide risk.

KEYWORDS:

• Suicidal ideation
• stroke survivors
• systematic review
• meta-analysis
• prevalence

Clinical trial registration

Systematic review registration: CRD42020171615

Supplementary material

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Additional information

Funding

This work was supported by the National Natural Science Foundation of China [81760352]; The Cultivation Fund of Hainan Medical University [HY2018-33]; High-level Talents Program of Hainan Natural Science Foundation [2019RC212]; Hainan Provincial Natural Science Foundation of China [819QN229]; CAMS Innovation Fund for Medical Sciences [2019-I2M-5-023]; Hainan Provincial Department of Science and Technology (CN) [ZDKJ201804].