Association between psychiatric disorders and the risk of stroke: a meta-analysis of cohort studies

队列 医学 冲程(发动机) 精神科 联想(心理学) 荟萃分析 队列研究 中风风险 缺血性中风 心理学 内科学 机械工程 缺血 工程类 心理治疗师
作者
Zhang Liang Hu,Wei-Shan Sun,En-Xiu Cui,Bo Chen,Mi Zhang
出处
期刊:Frontiers in Neurology [Frontiers Media]
卷期号:15
标识
DOI:10.3389/fneur.2024.1444862
摘要

Background Psychiatric disorders may be associated with an elevated risk of stroke; however, the existence of variations in this association between different populations remains controversial. Consequently, we conducted a comprehensive systematic review and meta-analysis to examine the magnitude of the relationship between psychiatric disorders and the risk of stroke. Methods The PubMed, Embase, and Cochrane Library databases were systematically searched to identify eligible studies from inception to April 2024. The aggregated findings were expressed as relative risks (RRs) with 95% confidence intervals (CIs), and the combined analysis was performed using a random-effects modeling approach. Further exploratory analyses were also performed using sensitivity and subgroup analyses. Results A total of 36 cohort studies, involving 25,519,635 individuals, were selected for analysis. We noted that depression (RR: 1.50; 95% CI: 1.34–1.68; p < 0.001), schizophrenia (RR: 1.74; 95% CI: 1.36–2.24; p < 0.001), and bipolar disorder (RR: 1.65; 95% CI: 1.27–2.14; p < 0.001) were associated with an elevated risk of stroke. Further exploratory analyses found that the association between depression and the risk of stroke differed according to the adjusted level (RR ratio: 0.77; 95% CI: 0.61–0.98; p = 0.034), and the association between schizophrenia and the risk of stroke differed according to the outcome definition (RR ratio: 0.68; 95% CI: 0.52–0.90; p = 0.006). Moreover, the association between bipolar disorder and the risk of stroke differed according to the study design (RR ratio: 0.68; 95% CI: 0.55–0.84; p < 0.001). Conclusion The significant association between psychiatric disorders and an elevated risk of stroke highlights the importance of enhanced monitoring and stroke prevention in patients with psychiatric disorders. Systematic review registration Our study was registered on the INPLASY platform (number: INPLASY202450049).
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