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Published on: August 30, 2020
Depression after Subarachnoid Hemorrhage: A Systematic Review
Wai Kwong Tang1, Lisha Wang1, George Kwok Chu Wong2
1Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.
Insights
Depression is a frequent and persistent complication following subarachnoid hemorrhage (SAH), impacting patient quality of life. Further research is needed to understand its development and effective treatments.
Area of Science:
- Neurology
- Psychiatry
- Public Health
Background:
- Depression frequently complicates neurological disorders, including non-traumatic subarachnoid hemorrhage (SAH).
- Understanding post-SAH depression is crucial due to its debilitating nature and impact on recovery.
Purpose of the Study:
- To systematically review studies on the frequency, severity, and time course of depression after SAH.
- To identify factors associated with post-SAH depression and its impact on quality of life.
Main Methods:
- A systematic search of the PubMed database was conducted.
- Studies included were published in English, involved patients over 18 years old, and had at least 40 participants diagnosed with depression post-SAH.
Main Results:
- 55 studies involving 6,327 patients were analyzed.
- The weighted proportion of depression after SAH was 28.1%, persisting long-term.
- Associated factors included female sex, prior depression, anxiety, substance use, cognitive impairment, fatigue, and physical disability.
Conclusions:
- Depression is a common and persistent condition following SAH.
- Further research is required to elucidate the neurobiological underpinnings and temporal patterns of post-SAH depression.
- Randomized controlled trials for treating SAH-related depression are necessary.
Background And Purpose:
Depression is common and debilitating illness accompanying many neurological disorders including non-traumatic subarachnoid hemorrhage (SAH). The aim of this systematic review was to identify and critically appraise all published studies that have reported the frequency, severity and time course of depression after SAH, the factors associated with its development and the impact of depression on patients' quality of life after SAH.
Methods:
The PubMed database was searched for studies published in English that recruited at least 40 patients (>18 years old) after SAH who were also diagnosed with depression.
Results:
Altogether 55 studies covering 6,327 patients met study entry criteria. The frequency of depression ranged from 0% to 61.7%, with a weighted proportion of 28.1%. Depression remained common even several years after the index SAH. Depression after SAH was associated with female sex, premorbid depression, anxiety, substance use disorders or any psychiatric disorders, and coping styles. Comorbid cognitive impairment, fatigue, and physical disability also increased the risk of depression. Aneurysmal SAH and infarction may be related to depression as well. Depression reduces the quality of life and life satisfaction in patients after SAH.
Conclusions:
Depression is common after SAH and seems to persist. Further research is needed to clarify its time course and identify the neuroendocrine and neurochemical factors and brain circuits associated with the development of post-SAH depression. Randomized controlled treatment trials targeting SAH-related depression are warranted.
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