Anxiety and depression symptoms after angiographically negative spontaneous subarachnoid hemorrhage.

OBJECTIVE

To investigate the risk factors of anxiety and/or depression after angiographically negative spontaneous subarachnoid hemorrhage (anSAH).

METHODS

We performed a retrospective review of a prospectively database for anSAH patients between January 2014 and June 2019. AnSAH was defined as SAH present in CT scans with no underlying vascular abnormality on initial digital subtraction angiography (DSA). Baseline demographics, angiographic features and hospitalization course were carefully reviewed. Depression or anxiety symptoms were assessed with the Hamilton Scales for anxiety and depression (HAMA and HAMD). Anxiety symptom and depression symptom were defined as a total score of HAMA–14 > 7 points and HAMD–24 ≥ 8 points, respectively.

RESULTS

Among 310 enrolled patients, anxiety and/or depression symptoms occurred in 34 (11.0%) patients. Multivariate logistic analysis showed that age < 55 years, modified Fisher Scale (mFS) 3–4 and length of hospital stays (LOS) > 10 days were independent risk factors of anxiety and/or depression in patients with anSAH. Additionally, the area under characteristic for multivariate factors (age, mFS and LOS) was 0.703. The incidence rate for anxiety and/or depression symptoms in the low-risk group (without any of risk factors) and high-risk group (with three risk factors) was 2.78% and 33.30%, respectively.

CONCLUSIONS

In patients with anSAH, age < 55 years, mFS 3–4 and LOS > 10 days were associated with a high risk of anxiety and/or depression symptoms, and these factors demonstrated acceptable predictive efficacy for psychological distresses. Furthermore, the incidence of anxiety and/or depression in the high–risk group was high, warranting the need for early psychological support in this group.