title: Ischemic Stroke in Young Adults and Preexisting Psychiatric Disorders: A Nationwide Case-Control Study.
abstract: Previous studies showed that psychiatric disorders such as major depression, bipolar disorders, and alcohol misuse are associated with an increased risk of ischemic stroke. However, the link between psychiatric disorders and stroke in the young population is rarely investigated. Using the Taiwan National Health Insurance Research Database, 2063 young adults aged between 18 and 45 years with ischemic stroke and 8252 age- and sex-matched controls were enrolled in our study between 1998 and 2011. Participants who had preexisting psychiatric disorders were identified. After adjusting for preexisting physical disorders and demographic data, patients with ischemic stroke had an increased risk of having preexisting psychiatric disorders, including bipolar disorder (odds ratio [OR]: 2.23, 95% confidence interval [CI]: 1.06∼4.67), unipolar depression (OR: 2.15, 95% CI: 1.62∼2.86), anxiety disorders (OR: 2.63, 95% CI: 1.87∼3.69), and alcohol use disorders (OR: 2.86, 95% CI: 1.79∼4.57). Young ischemic stroke (age ≥30 years) was related to the risk of preexisting unipolar depression (OR: 1.49, 95% CI: 1.05∼2.11), anxiety disorders (OR: 1.99, 95% CI: 1.33∼2.97), and alcohol use disorders (OR: 2.54, 95% CI: 1.55∼4.14); very young stroke (age <30 years) was only associated with the risk of preexisting unipolar depression (OR: 4.15, 95% CI: 1.47∼11.72). Patients who had experienced ischemic stroke at age younger than 45 years had a higher risk of having pre-existing bipolar disorder, unipolar depression, anxiety disorders, and alcohol use disorders than those who did not after adjusting for demographic data and stroke-related medical comorbidities.
authors.affiliation: From the Department of Psychiatry, MacKay Memorial Hospital (Y-CC); Department of Psychiatry, Taipei Veterans General Hospital (Y-MB, T-PS, M-HC); Department of Psychiatry, College of Medicine (Y-MB, T-PS, M-HC); Institute of Brain Science, National Yang-Ming University (T-PS); Department of Family Medicine, Taipei Veterans Hospital (T-JC); and Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan (T-JC).
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Chiu
authors.forename: Ya-Mei
authors.initials: YM
authors.lastname: Bai
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Mu-Hong
authors.initials: MH
authors.lastname: Chen
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000150:complications*; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D013624:Taiwan / Q000453:epidemiology