情绪障碍和中风常常并存，其对全球健康的影响巨大。本研究描述了情绪障碍在中风中的预后和因果作用。我们测试了情绪障碍的遗传易感性是否与所有中风、马尔默饮食和癌症队列中的缺血性中风（24,631名个体，中位随访21.3（四分位数范围：16.6-23.2）年）相关。我们进一步使用情绪障碍的大规模全基因组关联研究（高达609,424个体，精神病学基因组联盟）、所有中风和缺血性中风的摘要统计（高达446,696个体，MEGASTROKE联盟）来检查情绪障碍对所有中风和缺血性中风的因果效应。在初始时没有中风的24,366位参与者中，有2632人在随访期间发生了中风，其中2172人是缺血性中风。经过适当调整已知的风险因素后，情绪障碍多基因风险评分最高五分位数的参与者与女性最低五分位数相比，中风风险提高了1.45倍（95％CI，1.21-1.74），缺血性中风风险提高了1.44倍（95％CI，1.18-1.76）。门冬氨酸基因随机化分析表明情绪障碍对中风（比值比，1.07 [95％CI，1.03-1.11]）和缺血性中风（比值比，1.09 [95％CI，1.04-1.13]）具有因果效应。我们的结果表明，情绪障碍在中风风险中具有因果作用。可以使用多基因风险评分在生命早期识别高风险女性，以最终预防情绪障碍和中风。

Mood disorders and strokes are often comorbid, and their health toll worldwide is huge. This study characterizes prognostic and causal roles of mood disorders in stroke.We tested if genetic susceptibilities for mood disorders were associated with all strokes, ischemic strokes in the Malmö Diet and Cancer cohort (24 631 individuals with a median follow-up of 21.3 (interquartile range: 16.6-23.2) years. We further examined the causal effects for mood disorders on all strokes and ischemic strokes using summary statistics from large genome-wide association studies of mood disorders (up to 609 424 individuals, Psychiatric Genomics Consortium), all strokes and ischemic strokes (up to 446 696 individuals, MEGASTROKE Consortium).Among 24 366 stroke-free participants at baseline, 2632 individuals developed strokes, 2172 of them ischemic, during follow-up. After properly adjusting for well-known risk factors, participants in the highest quintile of polygenic risk scores for mood disorders had 1.45× (95% CI, 1.21-1.74) higher risk of strokes and 1.44× (95% CI, 1.18-1.76) higher risk of ischemic strokes compared with the lowest quintile in women. Mendelian randomization analyses suggested that mood disorders had a causal effect on strokes (odds ratio, 1.07 [95% CI, 1.03-1.11]) and ischemic strokes (odds ratio, 1.09 [95% CI, 1.04-1.13]).Our results suggest a causal role of mood disorders in the risk of stroke. High-risk women could be identified early in life using polygenic risk scores to ultimately prevent mood disorders and strokes.