Antidepressant Use After Aneurysmal Subarachnoid Hemorrhage: A Population-Based Case-Control Study

Area of Science:

• Neurology
• Psychiatry
• Epidemiology

Background:

• Subarachnoid hemorrhage from saccular intracranial aneurysms (sIA-SAH) can lead to long-term psychological sequelae.
• Depression is a common complication following neurological injury, impacting patient recovery and quality of life.

Purpose of the Study:

• To identify predictors of antidepressant use in survivors of sIA-SAH.
• To develop a predictive model for antidepressant use in this patient population using a population-based cohort.

Main Methods:

• Utilized the Kuopio sIA database, including matched controls, and linked it with the Finnish national registry of prescribed medicines.
• Defined antidepressant use as 2 or more purchases of antidepressant medication.
• Employed classification tree analysis to identify risk factors and build a predictive model for antidepressant use in 940 12-month survivors of sIA-SAH.

Main Results:

• Survivors of sIA-SAH showed significantly higher antidepressant use (29%) compared to matched controls (14%), with an odds ratio of 2.6.
• The most potent predictor for antidepressant use was the Modified Rankin Scale score at 12 months post-sIA-SAH.
• Other significant predictors included the initial condition severity (Hunt and Hess Scale) and age at admission.

Conclusions:

• Survivors of sIA-SAH exhibit a substantially increased likelihood of depression requiring antidepressant medication compared to the general population.
• Even individuals with a seemingly good functional recovery (Modified Rankin Scale score of 0) at 12 months remain at significant risk for depression.
• These findings underscore the importance of continued psychiatric monitoring for sIA-SAH survivors, irrespective of initial neurological recovery.