Journal article
Fatalism, Optimism, Spirituality, Depressive Symptoms, and Stroke Outcome: A Population-Based Analysis
Stroke (1970), v 42(12), pp 3518-3523
Dec 2011
PMID: 21940963
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background and Purpose— We sought to describe the association of spirituality, optimism, fatalism, and depressive symptoms with initial stroke severity, stroke recurrence, and poststroke mortality. Methods— Stroke cases from June 2004 to December 2008 were ascertained in Nueces County, TX. Patients without aphasia were queried on their recall of depressive symptoms, fatalism, optimism, and nonorganizational spirituality before stroke using validated scales. The association between scales and stroke outcomes was studied using multiple linear regression with log-transformed National Institutes of Health Stroke Scale and Cox proportional hazards regression for recurrence and mortality. Results— Six hundred sixty-nine patients participated; 48.7% were women. In fully adjusted models, an increase in fatalism from the first to third quartile was associated with all-cause mortality (hazard ratio, 1.41; 95% CI, 1.06–1.88) and marginally associated with risk of recurrence (hazard ratio, 1.35; 95% CI, 0.97–1.88), but not stroke severity. Similarly, an increase in depressive symptoms was associated with increased mortality (hazard ratio, 1.32; 95% CI, 1.02–1.72), marginally associated with stroke recurrence (HR, 1.22; 95% CI, 0.93–1.62), and with a 9.0% increase in stroke severity (95% CI, 0.01–18.0). Depressive symptoms altered the fatalism–mortality association such that the association of fatalism and mortality was more pronounced for patients reporting no depressive symptoms. Neither spirituality nor optimism conferred a significant effect on stroke severity, recurrence, or mortality. Conclusions— Among patients who have already had a stroke, self-described prestroke depressive symptoms and fatalism, but not optimism or spirituality, are associated with increased risk of stroke recurrence and mortality. Unconventional risk factors may explain some of the variability in stroke outcomes observed in populations and may be novel targets for intervention.
Metrics
Details
- Title
- Fatalism, Optimism, Spirituality, Depressive Symptoms, and Stroke Outcome
- Creators
- Lewis B Morgenstern - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXBrisa N Sánchez - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXLesli E Skolarus - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXNelda Garcia - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXJan M.H Risser - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXJeffrey J Wing - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXMelinda A Smith - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXDarin B Zahuranec - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TXLynda D Lisabeth - From the Stroke Program (L.B.M., L.E.S., N.G., M.A.S., D.B.Z., L.D.L.), University of Michigan Medical School, Ann Arbor, MI; the Departments of Epidemiology (L.B.M., L.D.L.) and Biostatistics (B.N.S., J.J.W.), University of Michigan School of Public Health, Ann Arbor, MI; and the Department of Epidemiology (J.M.H.R.), University of Texas at Houston School of Public Health, Houston, TX
- Publication Details
- Stroke (1970), v 42(12), pp 3518-3523
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000297941500041
- Scopus ID
- 2-s2.0-82555202151
- Other Identifier
- 991014877833104721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Peripheral Vascular Disease