학술논문

Longitudinal associations between stroke and psychosis: a population-based study.
Document Type
Article
Source
Psychological Medicine. Dec2023, Vol. 53 Issue 16, p7698-7706. 9p.
Subject
*STROKE
*CONFIDENCE intervals
*PSYCHOSES
*RISK assessment
*SOCIOECONOMIC factors
*KAPLAN-Meier estimator
*HEALTH behavior
*RESEARCH funding
*LOGISTIC regression analysis
*COMORBIDITY
*LONGITUDINAL method
*PROPORTIONAL hazards models
*DISEASE complications
Language
ISSN
0033-2917
Abstract
Background: The co-occurrence of stroke and psychosis is a serious neuropsychiatric condition but little is known about the course of this comorbidity. We aimed to estimate longitudinal associations between stroke and psychosis over 10 years. Methods: A 10-year population-based study using data from the English Longitudinal Study of Ageing. A structured health assessment recorded (i) first-occurrence stroke and (ii) psychosis, at each wave. Each were considered exposures and outcomes in separate analyses. Logistic and Cox proportional hazards regression and Kaplan–Meier methods were used. Models were adjusted for demographic and health behaviour covariates, with missing covariates imputed using random forest multiple imputation. Results: Of 19 808 participants, 24 reported both stroke and psychosis (median Wave 1 age 63, 71% female, 50% lowest quintile of net financial wealth) at any point during follow-up. By 10 years, the probability of an incident first stroke in participants with psychosis was 21.4% [95% confidence interval (CI) 12.1–29.6] compared to 8.3% (95% CI 7.8–8.8) in those without psychosis (absolute difference: 13.1%; 95% CI 20.8–4.3, log rank p < 0.001; fully-adjusted hazard ratio (HR): 3.57; 95% CI 2.18–5.84). The probability of reporting incident psychosis in participants with stroke was 2.3% (95% CI 1.4–3.2) compared to 0.9% (95% CI 0.7–1.1) in those without (absolute difference: 1.4%; 95% CI 0.7–2.1, log rank p < 0.001; fully-adjusted HR: 4.98; 95% CI 2.55–9.72). Conclusions: Stroke is an independent predictor of psychosis (and vice versa), after adjustment for potential confounders. [ABSTRACT FROM AUTHOR]