Artikel
Incidence of depression, anxiety and posttraumatic stress disorders in patients one year after aneurysmal subarachnoid hemorrhage
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Autoren
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Florian Schraml
- Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik, München, Deutschland
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Sebastian Ille
- Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik, München, Deutschland
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Youssef Shiban
- Universitätsklinikum Regensburg, Experimentelle Psychologie (Klinische Psychologie und Psychotherapie), Regensburg, Deutschland
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Bernhard Meyer
- Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik, München, Deutschland
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Ehab Shiban
- Technische Universität München, Klinikum rechts der Isar, Neurochirurgische Klinik, München, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: Subarachnoid bleeding is a highly traumatic event for patients. While the recovery from cognitive and physical impairment is well monitored, evaluation of the psychological outcome is still lacking.
Methods: An observational study of patients following treatment for aneurysmal SAH between October 2014 and April 2016 was performed. At one-year follow-up, patients were asked to complete a questionnaire, to evaluate the occurrence of depression (ADS-K) and anxiety disorders (STAI-S/-T & PTSS). In addition, the health related quality of life - using the SF36 questionnaire - was calculated. The incidence of psychiatric comorbidities was examined and correlated with clinical outcome.
Results: 35 patients met all inclusion criteria. 24 patients were female (68.6%), mean age 52.7 years. 28 patients were married or currently in a steady relationship (80.0%). Most patients presented with H&H grade 2 (57.1%). Abnormal STAI-S/-T (score of ≥40) were encountered in 17 and 16 cases respectively (48.6% & 45.7%). Abnormal ADS-K scores were seen in 31.4% of the cases. Furthermore 42.8% of patients had elevated PTSS-10 scores. The mean SF36 MCS was 45.5, while the mean SF36 PCS was 46.4. No significant differences between Clipping/Coiling could be found in either of the scores.
However patients who had described their respective hospitalization as "highly" or "extremely" mentally stressful had more concerning results in the ADS-K (17.8 vs 9.2; P=0.010), MCS (38.9 vs 49.1; P=0.020) and PTSS-10 (14.9 vs 8.7; P=0.112) than the patients who had described it as "somewhat" or "not at all" mentally stressful.
Conclusion: The incidence of depression and anxiety disorders in patients who have suffered from SAH is particularly high. Although neither the severity of bleeding nor the intervention affected the psychological outcome, the subjective experience of hospitalization seemed to do so. Additional testing will be necessary to further evaluate the importance of this factor.
