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World journal of psychiatry · 2025

Psychiatric sequelae following aneurysmal subarachnoid hemorrhage: Insights from a high-volume neurosurgical center in northern China.

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Wang Zhong-Xiao, Gao Xin-Yue, Cao Yun-Peng, Li Ke-Xin

Аннотация

BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH), a particularly devastating subtype of stroke, is associated with substantial rates of mortality and long-term functional impairment. Despite notable progress in therapeutic strategies, a considerable proportion of aSAH survivors continue to suffer from neuropsychiatric complications, most commonly anxiety and depression, which detrimentally impact their overall quality of life.

AIM: To investigate the prevalence of anxiety and depressive symptoms in patients with aSAH and to identify associated clinical risk factors.

METHODS: Clinical records of 1268 consecutive patients diagnosed with aSAH and treated between 2016 and 2022 were retrospectively reviewed. At follow-up, psychological assessments were performed using the Hospital Anxiety and Depression Scale to quantify symptoms of anxiety and depression. To identify independent predictors associated with these psychological outcomes post-aSAH, both univariate and multivariate statistical analyses were employed.

RESULTS: Among the studied cohort, 34.9% of patients presented with anxiety symptoms, while 31.8% demonstrated depressive features. Multivariate analysis identified female sex, presence of multiple aneurysms, a positive family history of cerebral hemorrhage, and receiving surgical clipping as independent predictors of anxiety. In contrast, significant predictors of depression included female sex, multiplicity of aneurysms, posterior circulation aneurysm localization, and poor clinical outcome. Notably, age above 60 years and documented functional recovery were associated with a reduced risk of depression.

CONCLUSION: Anxiety and depression are common neuropsychiatric sequelae in survivors of aSAH, each associated with a distinct set of risk factors. Early identification and targeted management of these risk profiles may facilitate more effective intervention strategies for psychological comorbidities, ultimately contributing to improved long-term patient outcomes.