Bell Vaughan, Tamayo-Agudelo William, Revill Grace, Okai David, Poole Norman
Research Department of Clinical, Educational and Health Psychology, University College London, UK; and Department of Neuropsychiatry, South London and Maudsley NHS Foundation Trust, London, UK.
Research Department of Clinical, Educational and Health Psychology, University College London, UK; and Universidad Cooperativa de Colombia, Medellín, Colombia.
BJPsych Open. 2023 Apr 17;9(3):e71. doi: 10.1192/bjo.2023.47.
Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association.
To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set.
Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook.
The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34-5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94-4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05-5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses.
Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services.
中风和精神病都与严重的残疾程度独立相关。然而，中风背景下的精神病研究较少。迄今为止，尚无关于它们共同患病率和关联性的全人群研究。
利用来自两个高收入国家（英国和美国）以及两个中等收入国家（智利和哥伦比亚）具有全国代表性的精神病流行病学研究，估计中风和精神病的共同患病率及其统计学关联，随后在合并国家的数据集中进行分析。
计算患病率及95%置信区间。使用回归模型检验中风与精神病之间以及中风与精神病症状之间的统计学关联。通过对合并国家数据集进行个体参与者水平的荟萃分析计算总体估计值。该分析可作为计算笔记本在线获取。
中风患者中可能患有精神病的总体患病率为3.81%（95%置信区间2.34 - 5.82），可能患有精神病的患者中中风的患病率为3.15%（95%置信区间1.94 - 4.83）。中风与可能患有精神病之间经调整后的关联比值比为3.32（95%置信区间2.05 - 5.38）。在个体症状层面，未经调整和调整后的分析均显示，偏执、幻听和思维被动妄想与中风相关。
精神病与中风之间的关联率表明，可能存在一个临床需求高但研究不足且现有服务可能难以满足其需求的群体。
