Depression and post-traumatic stress disorder after aneurysmal subarachnoid haemorrhage in relation to lifetime psychiatric morbidity

Figures & data

Table I. Patient characteristics

Included (N)	93
Death	−2
Dysphasia	−2
Did not want to participate	−2
Not available	−4
Study population	83
Males/females	30/53
Mean age in years	52 (SD = 9, range 30–74)
RLS85 at admission
1	63
2	14
3	3
4 or 5	3
RLS85 at discharge
1	73
2	9
3	1
Fisher grade
I–II	22
III–IV	61
WFNS
1	63
2	14
3	1
4 or 5	5
Ventricular drainage	30
Vasospasm	15
Type of aneurysm occlusion
Surgery	29
Coiling	54
Work status at SAH onset
Full-time/part time	44/22
Student	1
Retired	6
Sick leave or disability pension	10

Fig. 1. Flow chart of patients through each stage of the study presented according to the Consolidated Standards of Reporting Trials (CONSORT) statement (www.consort-statement.org/).

Table II. Prevalence rates of psychiatric diagnoses in the 83 patients admitted to the NICU

	Lifetime		12 months prior to SAH onset		7-month follow-up
	N	%	N	%	N	%
Any affective disorders	22	27	4	5	17	21*
Major depressive episode	22	27	3	4	17	21
Minor depressive episode	na	na	na	na	4^†	5
Manic or hypomanic episode	1	1	1	1	0	0
Dysthymia	2	2	0	0	0	0
Any anxiety disorder	22	27	11	13	26	31*
PTSD	7	8	1	1	15	18
Subsyndromal PTSD	na	na	na	na	10^‡	12
Panic disorder	6	7	1	1	2	2
Social phobia	6	7	6	7	6	7
Simple phobia	6	7	6	7	6	7
Psychosis UNS (not otherwise specified)	1	1	0	0	0	0
Any substance use disorder	11	13	3	4	3	4
Alcohol abuse/dependency	10	12	2	2	2	2
Drug abuse/dependency	4	5	1	1	1	1
Eating disorder	1	1	1	1	1	1
At least one disorder	37	45	16	19	34*	41*

na, not assessed.*Minor depression and subsyndromal PTSD not accounted for.^†Of whom, two had another disorder and one had subsyndromal PTSD.^‡Of whom, three had another disorder and one had minor depression.

Fig. 2. Number of patients with diagnoses of depression with respect to lifetime, 12 months prior to the SAH, and at follow-up 7 months after the SAH in the 83 investigated patients. Note: Presentation as in Schnyder et al.³² Numerals are numbers of patients; sizes of squares and arrows represent quantitative proportions.

Fig. 3. Number of patients with diagnoses of PTSD, subsyndromal PTSD and no PTSD with respect to lifetime, 12 months prior to the SAH, and at follow-up 7 months after the SAH in the 83 investigated patients. Note: Presentation as in Schnyder et al.³² Numerals are numbers of patients; sizes of squares and arrows represent quantitative proportions.

Table III. Logistic regressions with the presence of minor and major depressions, as well as subsyndromal and full PTSD at follow-up 7 months after SAH as dependent variables, and the presence of lifetime psychiatric disorders before SAH as independent variables

Lifetime disorders	Minor or major depression*		Subsyndromal or full PTSD^†
	OR	95% CI	p	OR	95% CI	p
Lifetime affective disorder	11.9	3.0–46	0.001	7.5	2.3–24	0.001
Lifetime anxiety disorder	6.5	1.6–26	0.008	2.0	0.6–6.0	ns
Lifetime substance use disorder	9.8	1.5–66	0.019	2.0	0.5–8.0	ns
Any psychiatric disorder lifetime	14.1	3.0–66	0.001	4.4	1.5–13	0.007
Psychiatric comorbidity	10.1	2.2–47	0.003	2.1	0.6–7.1	ns

Note: Clinical predictors with p <0.25 in simple binary regressions were adjusted for by forcing them into regressions as independent variables. OR, odds ratio; CI, confidence interval; ns, not significant.*Adjusted for Fisher grade, WFNS, ventricular drainage, vasospasm and female sex.†Adjusted for WFNS and female sex.

Schnyder U, Moergeli H, Klaghofer R, Buddeberg C. Incidence and prediction of post-traumatic stress disorder symptoms in severely injured accident victims. Am J Psychiatry 2001;158:594–9.

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