Stroke Risk Following Mental Disorders

An important recent manuscript published in JAMA Psychiatry looked at medical illnesses rates following diagnosis of a brain (mental) disorder.

This very large international study examined over 47,000 subjects followed between 2001 and 2011.

Baseline psychiatric assessment was completed using the Composite International Diagnostic Interview. Physical illness was assessed using a self-report of physician's diagnosis.

The manuscript is not free but I was able to obtain a professional courtesy copy of the manuscript from the lead author. 

The study found that a diagnosis of a mental disorder increased rates for a variety of later physical conditions.

I have put together a graph of the mental disorders associated with higher rates of later stroke (above).

Bulimia nervosa showed a three fold increase in later stroke. I am not aware of this association previously being noted. Alcohol and drug use disorders are known to increase stroke risk and this was found in the study lending face validity support.

Additional mental disorders associated with later stroke were bipolar disorder and panic/agoraphobia. 

Bipolar disorder has been linked to higher risk of hypertension and smoking.

The implications of these findings include need for enhanced medical illness screening and risk factor reduction in those with a mental disorder diagnosis. 

I will look at some the other individual medical conditions in future posts.

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Scott KM, Lim C, Al-Hamzawi A, Alonso J, Bruffaerts R, Caldas-de-Almeida JM, Florescu S, de Girolamo G, Hu C, de Jonge P, Kawakami N, Medina-Mora ME, Moskalewicz J, Navarro-Mateu F, O'Neill S, Piazza M, Posada-Villa J, Torres Y, & Kessler RC (2015). Association of Mental Disorders With Subsequent Chronic Physical Conditions: World Mental Health Surveys From 17 Countries. JAMA psychiatry, 1-9 PMID: 26719969