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Anxiety and Depression after Spontaneous Subarachnoid Hemorrhage

Morris, Paul Graham Ph.D.; Wilson, J. T. Lindsay Ph.D.; Dunn, Laurence Ph.D.

doi: 10.1227/01.NEU.0000097198.94828.E1
Clinical Studies

OBJECTIVE: Relatively little attention has been paid to emotional outcome after subarachnoid hemorrhage (SAH). This study assessed levels of anxiety and depression among SAH survivors and related these to clinical indices.

METHODS: Seventy SAH patients from a consecutive series of neurosurgical admissions participated in semistructured assessments of functional outcome; 52 of the patients also returned standardized measures of emotional outcome. These data were compared with clinical indices collected during the initial hospital admission.

RESULTS: Moderate to severe levels of anxiety were present in approximately 40% of patients 16 months after hemorrhage, with approximately 20% experiencing moderate to severe levels of depression. Although anxiety was more likely to be reported at interview by those with an SAH of Fisher Grade 4, the standardized measures of anxiety and depression were not associated with severity of hemorrhage or any other clinical variables. Both anxiety and depression were significantly associated with outcome indices such as return to work and engagement in social activities.

CONCLUSION: Anxiety is a significant and lasting problem for approximately 40% of survivors of SAH. It is suggested that measures taken to prevent or treat such anxiety among survivors of SAH may serve to significantly improve functional outcome.

Section of Clinical and Health Psychology, University of Edinburgh, Edinburgh, Scotland

Department of Psychology, University of Stirling, Stirling, Scotland

Department of Neurosurgery, University of Glasgow, Glasgow, Scotland

Reprint requests:

Paul Graham Morris, Ph.D., Section of Clinical and Health Psychology, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh EH10 5HF, Scotland.

Email: p.g.morris@ed.ac.uk

Received, December 17, 2002.

Accepted, August 27, 2003.

Copyright © by the Congress of Neurological Surgeons