Patients with aneurysmal subarachnoid hemorrhage report a high prevalence of depression and anxiety at six months.
SAN FRANCISCO—Anxiety and depression are common in patients with aneurysmal subarachnoid hemorrhage, according to data presented at the 135th Annual Meeting of the American Neurological Association. While anxiety does not appear to be related to the severity of aneurysmal subarachnoid hemorrhage, depression is highly associated with poor recovery, reported Nerissa U. Ko, MD, Associate Professor of Clinical Neurology, and Assistant Director of Neurovascular Service, University of California, San Francisco, and colleagues.
Dr. Ko’s group sought to determine the prevalence and clinical predictors of mood disorders among 208 patients with aneurysmal subarachnoid hemorrhage at six months. The authors obtained longitudinal data regarding patients who were admitted to a high-volume, tertiary care center from August 2003 to January 2010. All patients underwent clinical assessments at six months with use of the Hospital Anxiety and Depression Scale (HADS), modified Rankin Scale, Glasgow Outcome Score, Telephone Interview for Cognitive Status, and Barthel Index. Logistic regression analysis for anxiety and depression included adjustment for clinical and demographic factors.
The mean age of participants was 54; 77% were white, and 73% were female. About 40% of subjects had undergone endovascular treatment, 38% had a history of hypertension, and 38% were current tobacco users.
Among the study group, 39 patients (19%) had elevated anxiety, and 21 patients (10%) had elevated depression scores, defined as a HADS score of greater than 11. “Anxiety at six months was not associated with clinical risk factors,” stated Dr. Ko. “Treatment with coil embolization showed a trend for anxiety, but only current tobacco use remained significant in multivariate models.
“Depression at six months occurred in younger subjects who were current tobacco users,” Dr. Ko continued. “Unlike anxiety, depression was significantly associated with poor functional and cognitive outcomes.”
The researchers noted that tobacco use among patients with aneurysmal subarachnoid hemorrhage may be a comorbidity rather than a risk factor. They also pointed out study limitations, which include potential biases related to participants who complete surveys for mood disorders as well as a lack of detailed information regarding treatment and pre-existing conditions.
—Colby Stong