Tang Wai Kwong, Caeiro Lara, Lau Chieh Grace, Liang Huajun, Mok Vincent, Ungvari Gabor S, Wong Ka Sing
Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, SAR, China.
Faculty of Medicine, Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal.
BMC Neurol. 2015 Apr 23;15:60. doi: 10.1186/s12883-015-0323-3.
Both apathy and suicide are common in poststroke patients. However, the association between poststroke apathy and suicide-related ideation (SI) in Chinese stroke patients is not clear and poorly understood. The aim of this study was to examine the association between apathy and SI in stroke.
A cross-sectional study was conducted to investigate the association in 518 stroke survivors from Acute Stroke Unit of the Prince of Wales Hospital in Hong Kong. Geriatric Mental State Examination-Version A (GMS) and Neuropsychiatric Inventory-apathy subscale (NPI-apathy) were employed to assess poststroke SI and apathy, respectively. Patients' clinical characteristics were obtained with the following scales: the National Institutes of Health Stroke Scale (NIHSS), the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale (GDS).
Thirty-two (6.2%) stroke survivors reported SI. The SI group had a significantly higher frequency of NPI-apathy than the non-SI group (31.2% vs 5.3%, p < 0.001). The SI group also had higher GDS scores (10.47 ± 3.17 vs 4.24 ± 3.71, p < 0.001). Regression analysis revealed that NPI-apathy (OR 2.955, 95% CI 1.142-7.647, p = 0.025) was a significant predictor of SI. The GDS score also predicted SI (OR 1.436, 95% CI 1.284-1.606, p < 0.001).
The current findings show that poststroke apathy is an independent predictor of SI 3 months after stroke. Early screening for and intervention targeting apathy through medication and psychological treatments may be necessary to improve stroke patients' apathy and reduce SI.
冷漠和自杀在中风后患者中都很常见。然而，中国中风患者中中风后冷漠与自杀相关意念（SI）之间的关联尚不清楚且了解不足。本研究的目的是探讨中风后冷漠与SI之间的关联。
进行了一项横断面研究，以调查香港威尔士亲王医院急性中风单元的518名中风幸存者中的这种关联。分别采用老年精神状态检查A版（GMS）和神经精神科问卷冷漠分量表（NPI-冷漠）来评估中风后的SI和冷漠。通过以下量表获取患者的临床特征：美国国立卫生研究院卒中量表（NIHSS）、简易精神状态检查表（MMSE）和老年抑郁量表（GDS）。
32名（6.2%）中风幸存者报告有SI。SI组的NPI-冷漠频率显著高于非SI组（31.2%对5.3%，p<0.001）。SI组的GDS评分也更高（10.47±3.17对4.24±3.71，p<0.001）。回归分析显示，NPI-冷漠（比值比2.955，95%置信区间1.142 - 7.647，p = 0.025）是SI的显著预测因素。GDS评分也可预测SI（比值比1.436，95%置信区间1.284 - 1.606，p<0.001）。
目前的研究结果表明，中风后冷漠是中风后3个月SI的独立预测因素。通过药物和心理治疗对冷漠进行早期筛查和干预可能有必要，以改善中风患者的冷漠状况并降低SI。
