Psychological adjustment and depression after SAH

  • B. O. Hütter


In the chronic state after SAH, increased irritability, changes of personality, loss of interests and initiative, social problems and emotional disturbances frequently persist (Hütter, 1998; Ogden, Utley and Mee, 1997; Hütter, Gilsbach and Kreitschmann, 1995; Säveland et al., 1992; 1986; Stegen and Freckmann, 1991; Maurice-Williams et al., 1991; Vilkki et al., 1990; Sonesson et al., 1989; 1987; Bornstein et al., 1987; Ljunggren et al., 1985). These psychological disturbances and subjective complaints are also present when the degree of neurological and/or cognitive impairments is relatively mild (Hütter, 1998; Hütter, Gilsbach and Kreitschmann, 1995; Stegen and Freckmann, 1991; Vilkki et al., 1990; Ljunggren et al., 1985). Ropper and Zervas (1984) investigated a series of 112 consecutive cases after aneurysm rupture presenting with a good neurological recovery and detected in 25% of their patients, substantial emotional disturbances. Ljunggren et al. (1985) reported that 25% of their SAH patients with a good neurological result (GOS = I) complained of emotional problems in a clinical interview. Säveland et al. (1986) determined that of 21 patients after SAH and aneurysm rupture 5 (24%) exhibited severe psychosocial impairments. Taking into account the neuropsychological result, in a consecutive series of 87 patients after aneurysm rupture, only 33% exhibited a good neurological and psychosocial result (Säveland et al., 1986). Bornstein et al. (1987) also found frequent emotional disturbances in SAH patients who had been investigated by means of a clinical interview and the Minnesota Multiphasic Personality Inventory (MMPI). In a further study Vilkki et al. (1990) described changes of personality and emotional problems in a sample of patients after SAH investigated by means of standardized personality tests. In 32% of the patients, Vilkki et al. (1990) found significant changes of personality. In a collective of 87 patients after SAH with a mostly good neurological recovery (GOS = I), Stegen and Freckmann (1991) observed in almost all of their patients (98%) changes in social behavior, a deteriorated mood in 51% and depression in 36% of them. Mercier et al. (1991) found in 35% of their patients three months after aneurysm rupture evidence for changes of personality and emotional disturbances. Ogden, Henning and Mee (1993a) reported that one year after SAH, mostly as a consequence of aneurysm rupture, 14.6% of their patients exhibited a clinically significant depression in the BDI. Tidswell et al. (1995) found among 37 patients after aneurysm rupture 16% with a significant depression according to the criteria of the BDI. In patients with ruptured ACoA aneurysms, a statistically insignificant trend toward a lower level of depression was seen (p = 0.06). Ogden, Mee and Henning (1994) found in 19% of their patients one year after the acute hemorrhage a clinically relevant depression by means of the BDI.


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Psychological Adjustment Emotional Disturbance Aneurysm Rupture 
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© Springer-Verlag Wien 2000

Authors and Affiliations

  • B. O. Hütter
    • 1
  1. 1.RWTHNeurochirurgische UniversitätsklinikAachenGermany

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