Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies
Background. Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association. Aims. To estimate the joint prevalence...
- Autores:
-
Bell, Vaughan
Tabares Hernández, Christhian Steven
Revill, Grace
Okai, David
Poole, Norman
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2023
- Institución:
- Universidad Cooperativa de Colombia
- Repositorio:
- Repositorio UCC
- Idioma:
- OAI Identifier:
- oai:repository.ucc.edu.co:20.500.12494/52062
- Palabra clave:
- Stroke
Psychotic
Delusions
Hallucinations
Neuropsychiatry
Stroke
Psychotic
Delusions
Hallucinations
Neuropsychiatry
- Rights
- openAccess
- License
- Atribución
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| dc.title.none.fl_str_mv |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| title |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| spellingShingle |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies Stroke Psychotic Delusions Hallucinations Neuropsychiatry Stroke Psychotic Delusions Hallucinations Neuropsychiatry |
| title_short |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| title_full |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| title_fullStr |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| title_full_unstemmed |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| title_sort |
Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies |
| dc.creator.fl_str_mv |
Bell, Vaughan Tabares Hernández, Christhian Steven Revill, Grace Okai, David Poole, Norman |
| dc.contributor.author.none.fl_str_mv |
Bell, Vaughan Tabares Hernández, Christhian Steven Revill, Grace Okai, David Poole, Norman |
| dc.subject.none.fl_str_mv |
Stroke Psychotic Delusions Hallucinations Neuropsychiatry |
| topic |
Stroke Psychotic Delusions Hallucinations Neuropsychiatry Stroke Psychotic Delusions Hallucinations Neuropsychiatry |
| dc.subject.other.none.fl_str_mv |
Stroke Psychotic Delusions Hallucinations Neuropsychiatry |
| description |
Background. Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association. Aims. To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set. Method. Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook. Results. The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34–5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94–4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05–5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses. Conclusions. Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services. |
| publishDate |
2023 |
| dc.date.accessioned.none.fl_str_mv |
2023-07-18T14:02:53Z |
| dc.date.available.none.fl_str_mv |
2023-07-18T14:02:53Z |
| dc.date.issued.none.fl_str_mv |
2023-04-17 |
| dc.type.none.fl_str_mv |
Artículos Científicos |
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info:eu-repo/semantics/publishedVersion |
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http://purl.org/coar/version/c_970fb48d4fbd8a85 |
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info:eu-repo/semantics/article |
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| dc.identifier.issn.none.fl_str_mv |
20564724 |
| dc.identifier.uri.none.fl_str_mv |
https://doi.org/10.1192/bjo.2023.47 https://hdl.handle.net/20.500.12494/52062 |
| dc.identifier.bibliographicCitation.none.fl_str_mv |
Bell, V., Tamayo-Agudelo, W., Revill, G., Okai, D., & Poole, N. (2023). Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies. BJPsych Open, 9(3), E71. doi:10.1192/bjo.2023.47 |
| identifier_str_mv |
20564724 Bell, V., Tamayo-Agudelo, W., Revill, G., Okai, D., & Poole, N. (2023). Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies. BJPsych Open, 9(3), E71. doi:10.1192/bjo.2023.47 |
| url |
https://doi.org/10.1192/bjo.2023.47 https://hdl.handle.net/20.500.12494/52062 |
| dc.relation.isversionof.none.fl_str_mv |
https://www.cambridge.org/core/journals/bjpsych-open/article/association-between-stroke-and-psychosis-across-four-nationally-representative-psychiatric-epidemiological-studies/623A91CA7364696BE03B7A719C130411 |
| dc.relation.ispartofjournal.none.fl_str_mv |
BJPsych Open |
| dc.relation.references.none.fl_str_mv |
Su, C-C, Yang, Y-HK, Lai, EC-C, Hsieh, CY, Cheng, CL, Chen, CH, et al. Comparative safety of antipsychotic medications in elderly stroke survivors: a nationwide claim data and stroke registry linkage cohort study. J Psychiatr Res 2021; 139: 159–66. Stangeland, H, Orgeta, V, Bell, V. Poststroke psychosis: a systematic review. J Neurol Neurosurg Psychiatry 2018; 89: 879–85. Fleetwood, K, Wild, SH, Smith, DJ, Mercer, SW, Licence, K, Sudlow, CLM, et al. Association of severe mental illness with stroke outcomes and process-of-care quality indicators: nationwide cohort study. Br J Psychiatry 2022: 221(1): 394–401. Nielsen, RE, Banner, J, Jensen, SE. Cardiovascular disease in patients with severe mental illness. Nat Rev Cardiol 2021; 18: 136–45. Osborn, DPJ, Hardoon, S, Omar, RZ, Holt, RIG, King, M, Larsen, J, et al. Cardiovascular risk prediction models for people with severe mental illness: results from the prediction and management of cardiovascular risk in people with severe mental illnesses (PRIMROSE) research program. JAMA Psychiatry 2015; 72: 143–51. Appelros, P, Högerås, N, Terént, A. Case ascertainment in stroke studies: the risk of selection bias. Acta Neurol Scand 2003; 107: 145–9. Sipos, A, Harrison, G, Gunnell, D, Amin, S, Singh, SP. Patterns and predictors of hospitalisation in first-episode psychosis: prospective cohort study. Br J Psychiatry 2001; 178: 518–23. Feigin, VL, Lawes, CM, Bennett, DA, Barker-Collo, SL, Parag, V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 2009; 8: 355–69. Johnson, CO, Nguyen, M, Roth, GA, Nichols, E, Alam, T, Abate, D, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 2019; 18: 439–58. Bebbington, P, Nayani, T. The psychosis screening questionnaire. Int J Methods Psychiatr Res 1995; 5: 11–9. McManus, S, Meltzer, H, Brugha, T, Bebbington, PE, Jenkins, R. Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. Health & Social Care Information Centre, 2009. Kessler, RC, Üstün, TB. The world mental health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 2004; 13: 93–121. Heeringa, SG, Wagner, J, Torres, M, Duan, N, Adams, T, Berglund, P. Sample designs and sampling methods for the collaborative psychiatric epidemiology studies (CPES). Int J Methods Psychiatr Res 2004; 13: 221–40. Harding, TW, Arango, VD, Baltazar, J, Climent, CE, Ibrahim, HHA, Ladrido-Ignacio, L, et al. Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychol Med 1980; 10: 231–41. Gómez-Restrepo, C, de Santacruz, C, Rodriguez, MN, Rodriguez, V, Tamayo Martínez, N, Matallana, D, et al. Encuesta nacional de Salud mental Colombia 2015. Protocolo del estudio Revista Colombiana de Psiquiatría 2016; 45: 2–8. Ministerio de Salud. Encuesta Nacional De Salud 2016–2017 Primeros Resultados. 2017. Jakobsen, JC, Gluud, C, Wetterslev, J, Winkel, P. When and how should multiple imputation be used for handling missing data in randomised clinical trials – a practical guide with flowcharts. BMC Med Res Methodol 2017; 17: 162. Shah, AD, Bartlett, JW, Carpenter, J, Nicholas, O, Hemingway, H. Comparison of random forest and parametric imputation models for imputing missing data using MICE: a CALIBER study. Am J Epidemiol 2014; 179: 764–74. Rohrer, JM. Thinking clearly about correlations and causation: graphical causal models for observational data. Adv Methods Pract Psychol Sci 2018; 1: 27–42. Avan, A, Digaleh, H, Di Napoli, M, Stranges, S, Behrouz, R, Shojaeianbabaei, G, et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the global burden of disease study 2017. BMC Med 2019; 17: 191. Jongsma, HE, Turner, C, Kirkbride, JB, Jones, PB. International incidence of psychotic disorders, 2002–17: a systematic review and meta-analysis. Lancet Public Health 2019; 4: e229–44. Cox, AM, McKevitt, C, Rudd, AG, Wolfe, CD. Socioeconomic status and stroke. Lancet Neurol 2006; 5: 181–8. Addo, J, Ayerbe, L, Mohan, KM, Crichton, S, Sheldenkar, A, Chen, R, et al. Socioeconomic status and stroke. Stroke 2012; 43: 1186–91. Hakulinen, C, McGrath, JJ, Timmerman, A, Skipper, N, Mortensen, PB, Pedersen, CB, et al. The association between early-onset schizophrenia with employment, income, education, and cohabitation status: nationwide study with 35 years of follow-up. Soc Psychiatry Psychiatr Epidemiol 2019; 54: 1343–51. Pan, B, Jin, X, Jun, L, Qiu, S, Zheng, Q, Pan, M. The relationship between smoking and stroke. Medicine 2019; 98: e14872. Reynolds, K, Lewis, B, Nolen, JDL, Kinney, GL, Sathya, B, He, J. Alcohol consumption and risk of stroke: a meta-analysis. JAMA 2003; 289: 579–88. Jørgensen, KB, Nordentoft, M, Hjorthøj, C. Association between alcohol and substance use disorders and psychiatric service use in patients with severe mental illness: a nationwide Danish register-based cohort study. Psychol Med 2018; 48: 2592–600. Mustonen, A, Ahokas, T, Nordström, T, Murray, GK, Mäki, P, Jääskeläinen, E, et al. Smokin’ hot: adolescent smoking and the risk of psychosis. Acta Psychiatr Scand 2018; 138: 5–14. Hartz, SM, Pato, CN, Medeiros, H, Cavazos-Rehg, P, Sobell, JL, Knowles, JA, et al. Comorbidity of severe psychotic disorders with measures of substance use. JAMA Psychiatry 2014; 71: 248–54. Riley, RD, Lambert, PC, Abo-Zaid, G. Meta-analysis of individual participant data: rationale, conduct, and reporting. BMJ 2010; 340: c221. Li, M, Fan, Y-L, Tang, Z-Y, Cheng, X-S. Schizophrenia and risk of stroke: a meta-analysis of cohort studies. Int J Cardiol 2014; 173: 588–90. Marto, JP, Strambo, D, Livio, F, Michel, P. Drugs associated with ischemic stroke. Stroke 2021; 52: e646–59. Kisely, S, Campbell, LA, Wang, Y. Treatment of ischaemic heart disease and stroke in individuals with psychosis under universal healthcare. Br J Psychiatry 2009; 195: 545–50. Centers for Disease Control and Prevention. Prevalence of stroke – United States, 2005. MMWR Morb Mortal Wkly Rep 2007; 56: 469–74. Charlson, FJ, Ferrari, AJ, Santomauro, DF, Diminic, S, Stockings, E, Scott, JG, et al. Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophr Bull 2018; 44: 1195–203. van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L. A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychol Med 2009; 39: 179–95. Aked, J, Delavaran, H, Norrving, B, Lindgren, A. Completeness of case ascertainment in Swedish hospital-based stroke registers. Acta Neurol Scand 2020; 141: 148–55. Woodfield, R, UK Biobank Stroke Outcomes Group, UK Biobank Follow-up and Outcomes Working Group, Sudlow, CLM. Accuracy of patient self-report of stroke: a systematic review from the UK Biobank stroke outcomes group. PLoS One 2015; 10: e0137538. Walker, MK, Whincup, PH, Shaper, AG, Lennon, LT, Thomson, AG. Validation of patient recall of doctor-diagnosed heart attack and stroke: a postal questionnaire and record review comparison. Am J Epidemiol 1998; 148: 355–61. Joundi, RA, Smith, EE, Yu, AYX, Rashid, M, Fang, J, Kapral, MK. Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke. Neurology 2021; 96: e2037–47. Boot, E, Ekker, MS, Putaala, J, Kittner, S, Leeuw, F-ED, Tuladhar, AM. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry 2020; 91: 411–7. Cooper, SJ, Reynolds, GP, Barnes, T, England, E, Haddad, P, Heald, A, et al. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. J Psychopharmacol 2016; 30: 717–48. |
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Bell, VaughanTabares Hernández, Christhian StevenRevill, GraceOkai, DavidPoole, Norman92023-07-18T14:02:53Z2023-07-18T14:02:53Z2023-04-1720564724https://doi.org/10.1192/bjo.2023.47https://hdl.handle.net/20.500.12494/52062Bell, V., Tamayo-Agudelo, W., Revill, G., Okai, D., & Poole, N. (2023). Association between stroke and psychosis across four nationally representative psychiatric epidemiological studies. BJPsych Open, 9(3), E71. doi:10.1192/bjo.2023.47Background. Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association. Aims. To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set. Method. Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook. Results. The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34–5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94–4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05–5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses. Conclusions. Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services.https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000168041https://orcid.org/0000-0002-5858-4964https://scienti.minciencias.gov.co/gruplac/jsp/visualiza/visualizagr.jsp?nro=00000000004241william.tamayoa@campusucc.edu.cohttps://scholar.google.es/citations?user=RBbJI3sAAAAJ&hl=es1-7Universidad Cooperativa de Colombia, Facultad de Ciencias Sociales, Psicología, Medellín y EnvigadoPsicologíaMedellínhttps://www.cambridge.org/core/journals/bjpsych-open/article/association-between-stroke-and-psychosis-across-four-nationally-representative-psychiatric-epidemiological-studies/623A91CA7364696BE03B7A719C130411BJPsych OpenSu, C-C, Yang, Y-HK, Lai, EC-C, Hsieh, CY, Cheng, CL, Chen, CH, et al. Comparative safety of antipsychotic medications in elderly stroke survivors: a nationwide claim data and stroke registry linkage cohort study. J Psychiatr Res 2021; 139: 159–66.Stangeland, H, Orgeta, V, Bell, V. Poststroke psychosis: a systematic review. J Neurol Neurosurg Psychiatry 2018; 89: 879–85.Fleetwood, K, Wild, SH, Smith, DJ, Mercer, SW, Licence, K, Sudlow, CLM, et al. Association of severe mental illness with stroke outcomes and process-of-care quality indicators: nationwide cohort study. Br J Psychiatry 2022: 221(1): 394–401.Nielsen, RE, Banner, J, Jensen, SE. Cardiovascular disease in patients with severe mental illness. Nat Rev Cardiol 2021; 18: 136–45.Osborn, DPJ, Hardoon, S, Omar, RZ, Holt, RIG, King, M, Larsen, J, et al. Cardiovascular risk prediction models for people with severe mental illness: results from the prediction and management of cardiovascular risk in people with severe mental illnesses (PRIMROSE) research program. JAMA Psychiatry 2015; 72: 143–51.Appelros, P, Högerås, N, Terént, A. Case ascertainment in stroke studies: the risk of selection bias. Acta Neurol Scand 2003; 107: 145–9.Sipos, A, Harrison, G, Gunnell, D, Amin, S, Singh, SP. Patterns and predictors of hospitalisation in first-episode psychosis: prospective cohort study. Br J Psychiatry 2001; 178: 518–23.Feigin, VL, Lawes, CM, Bennett, DA, Barker-Collo, SL, Parag, V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol 2009; 8: 355–69.Johnson, CO, Nguyen, M, Roth, GA, Nichols, E, Alam, T, Abate, D, et al. Global, regional, and national burden of stroke, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 2019; 18: 439–58.Bebbington, P, Nayani, T. The psychosis screening questionnaire. Int J Methods Psychiatr Res 1995; 5: 11–9.McManus, S, Meltzer, H, Brugha, T, Bebbington, PE, Jenkins, R. Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. Health & Social Care Information Centre, 2009.Kessler, RC, Üstün, TB. The world mental health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 2004; 13: 93–121.Heeringa, SG, Wagner, J, Torres, M, Duan, N, Adams, T, Berglund, P. Sample designs and sampling methods for the collaborative psychiatric epidemiology studies (CPES). Int J Methods Psychiatr Res 2004; 13: 221–40.Harding, TW, Arango, VD, Baltazar, J, Climent, CE, Ibrahim, HHA, Ladrido-Ignacio, L, et al. Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychol Med 1980; 10: 231–41.Gómez-Restrepo, C, de Santacruz, C, Rodriguez, MN, Rodriguez, V, Tamayo Martínez, N, Matallana, D, et al. Encuesta nacional de Salud mental Colombia 2015. Protocolo del estudio Revista Colombiana de Psiquiatría 2016; 45: 2–8.Ministerio de Salud. Encuesta Nacional De Salud 2016–2017 Primeros Resultados. 2017.Jakobsen, JC, Gluud, C, Wetterslev, J, Winkel, P. When and how should multiple imputation be used for handling missing data in randomised clinical trials – a practical guide with flowcharts. BMC Med Res Methodol 2017; 17: 162.Shah, AD, Bartlett, JW, Carpenter, J, Nicholas, O, Hemingway, H. Comparison of random forest and parametric imputation models for imputing missing data using MICE: a CALIBER study. Am J Epidemiol 2014; 179: 764–74.Rohrer, JM. Thinking clearly about correlations and causation: graphical causal models for observational data. Adv Methods Pract Psychol Sci 2018; 1: 27–42.Avan, A, Digaleh, H, Di Napoli, M, Stranges, S, Behrouz, R, Shojaeianbabaei, G, et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the global burden of disease study 2017. BMC Med 2019; 17: 191.Jongsma, HE, Turner, C, Kirkbride, JB, Jones, PB. International incidence of psychotic disorders, 2002–17: a systematic review and meta-analysis. Lancet Public Health 2019; 4: e229–44.Cox, AM, McKevitt, C, Rudd, AG, Wolfe, CD. Socioeconomic status and stroke. Lancet Neurol 2006; 5: 181–8.Addo, J, Ayerbe, L, Mohan, KM, Crichton, S, Sheldenkar, A, Chen, R, et al. Socioeconomic status and stroke. Stroke 2012; 43: 1186–91.Hakulinen, C, McGrath, JJ, Timmerman, A, Skipper, N, Mortensen, PB, Pedersen, CB, et al. The association between early-onset schizophrenia with employment, income, education, and cohabitation status: nationwide study with 35 years of follow-up. Soc Psychiatry Psychiatr Epidemiol 2019; 54: 1343–51.Pan, B, Jin, X, Jun, L, Qiu, S, Zheng, Q, Pan, M. The relationship between smoking and stroke. Medicine 2019; 98: e14872.Reynolds, K, Lewis, B, Nolen, JDL, Kinney, GL, Sathya, B, He, J. Alcohol consumption and risk of stroke: a meta-analysis. JAMA 2003; 289: 579–88.Jørgensen, KB, Nordentoft, M, Hjorthøj, C. Association between alcohol and substance use disorders and psychiatric service use in patients with severe mental illness: a nationwide Danish register-based cohort study. Psychol Med 2018; 48: 2592–600.Mustonen, A, Ahokas, T, Nordström, T, Murray, GK, Mäki, P, Jääskeläinen, E, et al. Smokin’ hot: adolescent smoking and the risk of psychosis. Acta Psychiatr Scand 2018; 138: 5–14.Hartz, SM, Pato, CN, Medeiros, H, Cavazos-Rehg, P, Sobell, JL, Knowles, JA, et al. Comorbidity of severe psychotic disorders with measures of substance use. JAMA Psychiatry 2014; 71: 248–54.Riley, RD, Lambert, PC, Abo-Zaid, G. Meta-analysis of individual participant data: rationale, conduct, and reporting. BMJ 2010; 340: c221.Li, M, Fan, Y-L, Tang, Z-Y, Cheng, X-S. Schizophrenia and risk of stroke: a meta-analysis of cohort studies. Int J Cardiol 2014; 173: 588–90.Marto, JP, Strambo, D, Livio, F, Michel, P. Drugs associated with ischemic stroke. Stroke 2021; 52: e646–59.Kisely, S, Campbell, LA, Wang, Y. Treatment of ischaemic heart disease and stroke in individuals with psychosis under universal healthcare. Br J Psychiatry 2009; 195: 545–50.Centers for Disease Control and Prevention. Prevalence of stroke – United States, 2005. MMWR Morb Mortal Wkly Rep 2007; 56: 469–74.Charlson, FJ, Ferrari, AJ, Santomauro, DF, Diminic, S, Stockings, E, Scott, JG, et al. Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophr Bull 2018; 44: 1195–203.van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L. A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychol Med 2009; 39: 179–95.Aked, J, Delavaran, H, Norrving, B, Lindgren, A. Completeness of case ascertainment in Swedish hospital-based stroke registers. Acta Neurol Scand 2020; 141: 148–55.Woodfield, R, UK Biobank Stroke Outcomes Group, UK Biobank Follow-up and Outcomes Working Group, Sudlow, CLM. Accuracy of patient self-report of stroke: a systematic review from the UK Biobank stroke outcomes group. PLoS One 2015; 10: e0137538.Walker, MK, Whincup, PH, Shaper, AG, Lennon, LT, Thomson, AG. Validation of patient recall of doctor-diagnosed heart attack and stroke: a postal questionnaire and record review comparison. Am J Epidemiol 1998; 148: 355–61.Joundi, RA, Smith, EE, Yu, AYX, Rashid, M, Fang, J, Kapral, MK. Temporal trends in case fatality, discharge destination, and admission to long-term care after acute stroke. Neurology 2021; 96: e2037–47.Boot, E, Ekker, MS, Putaala, J, Kittner, S, Leeuw, F-ED, Tuladhar, AM. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry 2020; 91: 411–7.Cooper, SJ, Reynolds, GP, Barnes, T, England, E, Haddad, P, Heald, A, et al. BAP guidelines on the management of weight gain, metabolic disturbances and cardiovascular risk associated with psychosis and antipsychotic drug treatment. 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