Evidence map›Paper›PMID 41164924›Full record

ArticleActa psychiatrica Scandinavica2026

Risk of Stroke in Patients With Schizophrenia, Bipolar Disorder, and Major Depressive Disorder: A Cohort Study of 183,504 Subjects.

Mao-Hsuan Huang, Chih-Ming Cheng, Ju-Wei Hsu, Ya-Mei Bai, Tung-Ping Su, Cheng-Ta Li, Shih-Jen Tsai, Yee-Lam E Chan, Mu-Hong Chen

Abstract read
In one paragraph

Article in Acta psychiatrica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mao-Hsuan HuangDepartment of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan.ORCID 0000-0002-7970-3758
Chih-Ming ChengDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Ju-Wei HsuDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Ya-Mei BaiDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Tung-Ping SuDepartment of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan.
Cheng-Ta LiDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Shih-Jen TsaiDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.ORCID 0000-0002-9987-022X
Yee-Lam E ChanDepartment of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan.
Mu-Hong ChenDivision of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.ORCID 0000-0001-6516-1073

Funding

Ministry of Science and Technology, Taiwan 107-2314-B-075-063-MY3, 112-2314-B-A19-001, 113-2314-B-350-003, 114-2314-B-350-003Taipei Veterans General Hospital V103E10-001Taipei Veterans General Hospital V104E10-002Taipei Veterans General Hospital V105A-049Taipei Veterans General Hospital V105E10-001-MY2-1Taipei Veterans General Hospital V106B-020Taipei Veterans General Hospital V107B-010Taipei Veterans General Hospital V107C-181
6 · The paper itself

Abstract

backgroundMajor psychiatric disorder, including schizophrenia, bipolar disorder, and major depressive disorder, has been individually associated with increased risk of stroke. However, few studies have directly compared the stroke risk across these diagnostic groups within a unified cohort framework while accounting for stroke subtypes and relevant confounders.

methodsUsing Taiwan's National Health Insurance Research Database, we identified 30,945 patients with schizophrenia, 30,360 with bipolar disorder, 30,447 with major depressive disorder, and 91,752 age-matched controls without psychiatric illness between 2001 and 2009. Participants were followed until death or the end of 2011. Cox regression models were used to estimate the hazard ratio (HR) for ischemic and hemorrhagic stroke, adjusting for potential confounding factors. Sensitivity analyses were conducted by excluding stroke events occurring within the first 1 or 3 years of psychiatric diagnosis.

resultsAll three psychiatric groups exhibited significantly higher risks of ischemic and hemorrhagic stroke compared with controls. Stroke risk remained consistently elevated across age and sex strata for all psychiatric groups. Greater cumulative exposure to antidepressants was associated with reduced stroke risk across all three disorders; antipsychotics showed protective associations in schizophrenia and bipolar disorder, non-lithium mood stabilizers were protective only in bipolar disorder, and lithium showed no significant association with stroke risk.

conclusionSchizophrenia, bipolar disorder, and major depressive disorder are independently associated with increased stroke risk. These findings highlight the need for integrated vascular risk monitoring in psychiatric care.

Indexed as

Bipolar DisorderHemorrhagic StrokeIschemic StrokeMajor Depressive DisorderSchizophreniaStrokeAdultAgedAntidepressive AgentsAntipsychotic AgentsCase-Control StudiesCohort StudiesFemaleHumansMaleMiddle AgedAntidepressive AgentsAntipsychotic Agentsbipolar disordercerebrovascular eventschizophreniasevere mental illnessstroke

Identifiers

PMID41164924
PMCPMC12668889

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.