title: Is pain associated with suicidality in stroke?
abstract: OBJECTIVE
  To evaluate the relation between poststroke pain and suicidality (SI) in Chinese patients with first or recurrent stroke.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Acute stroke unit of a university-affiliated general hospital.
  
  
  METHODS
  Patients (N=496) with acute ischemic stroke admitted to the Acute Stroke Unit.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Patients were interviewed 3 months after the index stroke. SI was assessed with the Geriatric Mental State Examination. Pain was evaluated with the Faces Pain Rating Scale-Revised (FPS-R). The association between FPS-R scores and SI was examined and adjusted for potential confounders, including marital status, depression, neurologic deficits assessed by the National Institute of Health Stroke Scale, and functioning measured by the Barthel Index.
  
  
  RESULTS
  Thirty-seven (7.5%) of the patients had SI (the SI group). Compared with the non-SI group, patients in the SI group were more likely to experience pain (59.5% vs 37.7%), had a higher mean FPS-R score (6.0±2.5 vs 4.5±2.3), and had an FPS-R score of >4 (43.2% vs 15.9%). After adjustment for possible confounders, the FPS-R score of >4 (odds ratio=2.9) remained a significant predictor of SI in the subsequent forward logistic regression models.
  
  
  CONCLUSIONS
  These findings should alert clinicians that the early identification and treatment of pain may reduce suicide risk in patients with stroke.
authors.affiliation: Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. tangwk@cuhk.edu.hk
authors.forename: Wai Kwong
authors.initials: WK
authors.lastname: Tang
authors.forename: Huajun
authors.initials: H
authors.lastname: Liang
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.forename: Ka-Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000523:psychology*; D002681:China; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D019263:Dysthymic Disorder / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000209:etiology* / Q000523:psychology*; D010147:Pain Measurement; D020521:Stroke / Q000150:complications / Q000523:psychology*; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires