title: Apathy and suicide-related ideation 3 months after stroke: a cross-sectional study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, SAR, China. tangwk@cuhk.edu.hk.
authors.forename: Wai Kwong
authors.initials: WK
authors.lastname: Tang
authors.affiliation: Faculty of Medicine, Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal. laracaeiro@fm.ul.pt.
authors.forename: Lara
authors.initials: L
authors.lastname: Caeiro
authors.affiliation: Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, SAR, China. graceclau@cuhk.edu.hk.
authors.forename: Chieh Grace
authors.initials: CG
authors.lastname: Lau
authors.affiliation: Department of Psychiatry, Shatin Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, SAR, China. Lianghuajun@cuhk.edu.hk.
authors.forename: Huajun
authors.initials: H
authors.lastname: Liang
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China. vctmok@cuhk.edu.hk.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.affiliation: School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia. sungvari@e.cuhk.edu.hk.|University of Notre Dame Australia / Marian Centre, Perth, Australia. sungvari@e.cuhk.edu.hk.
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China. ks-wong@cuhk.edu.hk.
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D057565:Apathy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020521:Stroke / Q000523:psychology*; D059020:Suicidal Ideation