Table 2.
Studies of frequency and/or severity of depression after SAH
| Study | Study design and setting | Timing after SAH | Cut off point | Proportion of participants with depression (%) | Depressive symptom scores (mean±SD) | Limitations | |
|---|---|---|---|---|---|---|---|
| Depression measured by rating instruments/questionnaires | |||||||
| Alfieri et al. (2008) [17] | Longitudinal study, hospitalized patients | On admission (T1) | NR | NR | T1: 17.1±6.5 | Small sample size | |
| 1 mo (T2) | T2: 22.1±3.6 | ||||||
| 1 yr (T3) | T3: 19.9±4.8 | ||||||
| 3 yr (T4) | T4: 14.3±3.8 | ||||||
| 5 yr (T5) | T5: 13.2±3.8 | ||||||
| Caeiro et al. (2011) [54] | Prospective study, consecutive admissions to an academic neurosurgery center | ≤4 day | MADRS ≥7 | 45 | 9.2±7.3 | Sample biased towards SAH of mild severity, depression not assessed at subacute and chronic stage of SAH | |
| Meyer et al. (2010) [44] | Longitudinal study | At discharge (T1) | BDI >10 | T1: 24.8 | NR | Patients with aphasia excluded, possible confounders not measured. | |
| 12 mo (T2) | T2: 61.7 | ||||||
| Passier et al. (2010) [14], Passier et al. (2011) [15], Passier et al. (2012) [16] | Cross-sectional study, all subjects treated with clipping or coiling | 3 mo | BDI ≥10 | 40 | 9.6±6.9 | Nursing home patients not included. | |
| Powell et al. (2002) [18] and Powell et al. (2004) [19] | Cross-sectional study, consecutive admissions to a neurovascular service | 3 mo (T1) | BDI >10 | T1: 9.1 | T1: 9.6±6.2 | Small sample size | |
| 9 mo (T2) | T2: 11.4 | T2: 9.2±6.9 | |||||
| 18 mo (T3) | T3: 16.3 | T3: 9.4±7.3 | |||||
| Ackermark et al. (2017) [41] | Longitudinal study, subjects recruited from a clinic | 3 mo (T1) | BDI ≥10 | T1: 39 | T1: 8.9±7.0 | Nursing home patients not included, no data of previous mental health problems, locus of control, optimism or social support, self-report of depressive symptoms. | |
| 1 yr (T2) | T2: 41 | T2: 9.3±7.1 | |||||
| 2–5 yr (T3) | T3: 54 | T3: 11.2±8.0 | |||||
| Kronvall et al. (2016) [60] | Prospective study in an academic neurosurgery unit | 3–6 mo (T1) | NR | NR | T1: 15.0±3.5 | Small sample size, validity of the mood assessment uncertain | |
| 6–12 mo (T2) | T2: 15.3±2.9 | ||||||
| 12–24 mo (T3) | T3: 15.8±2.9 | ||||||
| Wong et al. (2012) [57] | Prospective multi-center study of consecutive admissions | 3 mo | NR | NR | 7 (median) | Lack of gold standard measure of depression | |
| Kreiter et al. (2013) [53] | Prospective study, consecutive admissions to an academic neurosurgery center | 3 mo (T1) | CESD ≥16 | T1: 38 | NR | Less severely affected subjects more likely to complete follow-up, subjects treated for SAH a decade ago, confounders not considered. | |
| 1 yr (T2) | T2: 33 | ||||||
| Boerboom et al. (2014) [22] and Boerboom et al. (2016) [23,24] | Prospective study, consecutive admissions to an academic neurosurgery center | 0.4 yr (T1) | CESD ≥16 | T2: 26.7 | T1: 13.7±1.2 | Subjects assessed at different time points following SAH. | |
| 3.9 yr (T2) | T2: 11.9±1.2 | ||||||
| Fontanella et al. (2003) [50] | Cross-sectional study, all subjects had treated anterior communicating artery bleeding aneurysm | 6 mo | NR | NR | 13.8 (SD NR) | Small sample size, limited generalizability to patients with other type of SAH | |
| von Vogelsang et al. (2015) [29] | Longitudinal study, hospitalized subjects | 6 mo (T1) | HADS ≥8 | T1: 25.0 | T1: 5.0 | No data on previous history of depression or use of antidepressants during the follow-up period | |
| 1 yr (T2) | T2: 27.6 | T2: 4.0 | |||||
| 2 yr (T3) | T3: 29.4 | T3: 5.0 (median) | |||||
| Hellawell et al. (1999) [39] | Longitudinal study, subjects recruited from a neurosurgical unit | 6 mo (T1) | NR | T1: 8 | NR | Small sample size, high attrition rate | |
| 1 yr (T2) | T2: 9 | ||||||
| 2 yr (T3) | T3: 5 | ||||||
| Brand et al. (2015) [65] | Case-control study, all subjects had treated SAH | 5–9 mo | NR | NR | 1.42±0.29 | Small sample size, validity of the mood assessment uncertain, confounders not measured. | |
| Pačić-Turk et al. (2016) [64] | Prospective study in an academic neurosurgery unit | 11 mo (T1) | NR | NR | T1: 1.93 | Modest sample size, validity of the mood assessment uncertain | |
| 12–48 mo (T2) | T2: 2.65 | ||||||
| Scherfler et al. (2016) [28] | Longitudinal study, subjects recruited from a neurological intensive care unit | 1 yr | HADS >10 | 0 | 1 (median) | Small sample size, selected inclusion of patients without visually detectable structural lesions on MRI | |
| Tölli et al. (2018) [25] | Longitudinal study, subjects recruited from a neruointensive care unit | 1 yr | HADS ≥8 | 23 | NR | Single center study, small sample size | |
| Orbo et al. (2008) [45] | Longitudinal study, all subjects treated with clipping | 1 yr | BDI ≥14 | 5 | 6 (SD NR) | Small sample size | |
| Preiss et al. (2007) [46] | Longitudinal study, all subjects treated with coiling or clipping | 1 yr | NR | NR | 9.4 | Relative small sample size, potential selection bias | |
| Haug et al. (2009) [55] | Prospective study, all subjects treated for anterior or middle cerebral artery bleeding aneurysm | 1 yr | NR | NR | 5.5 (SD NR) | Small sample size, subjects with other locations of aneurysms excluded. | |
| Taufique et al. (2016) [52] | Prospective study, consecutive admissions to an academic neurosurgery center | 1 yr | CESD ≥16 | 33.3 | NR | Poor grade patients more likely to be lost to follow-up. | |
| Mukerji et al. (2010) [35] | Retrospective subject recruitment, all subjects received an angiogram | Median 13 mo (range, 12–266) | NR | 13 | NR | Subjects recruited at different time points following SAH, small sample size | |
| Morris et al. (2004) [40] | Cross-sectional study, method and site of recruitment not reported | Average 16 mo (range, 14–23) | BDI ≥10 | 50 | NR | Small sample size, opportunity samples, subjects recruited at different time points following SAH | |
| Gill et al. (2015) [31] | Cross-sectional study, subjects recruited from neuropsychology services, charities and online support network | Average 21.1 mo (range, 2–58) | HADS ≥8 | 51 | NR | No data on those refused to participate, self-report data of SAH, severity of injury not recorded, subjects, recruited at different time points following SAH. | |
| Fertl et al. (1999) [51] | Cross-sectional study, all subjects treated for SAH | Average 22 mo (range, NR) | ≥12 | 28 | NR | Small sample size, subjects recruited at different time points following SAH | |
| Kreitschmann-An-dermahr et al. (2007) [47] | Cross-sectional study, method and site of recruitment not reported | Average 27.3 mo (range, 12–66) | BDI >10 | 37.5 | 8.33±5.85 | Small sample size, subjects recruited at different time points following SAH | |
| Wong et al. (2014) [3] | Cross-sectional four centers study, hospitalized subjects | Average NR (range, 1–4 yr) | - | 13 | NR | Attrition, subjects recruited at different time points following SAH, confounders not measured, reporting bias | |
| Visser-Meily et al. (2009) [36] | Cross-sectional study, all subjects had been treated with coiling or clipping | Average 3 yr (range, 2–4) | HADS ≥8 | 23 | 4.8±3.9 | Selection bias as only patients still alive included, subjects recruited at different time points following SAH. | |
| Noble et al. (2014) [32] | Cross-sectional study, subjects recruited from support groups | Median 3 yr (range, 1–5) | HADS ≥8 | 45.2 | NR | Only patients had access to internet included, no data on those refused to participate, lack of psychiatric interviews, self-report data of SAH details, subjects recruited at different time points following SAH. | |
| Hütter et al. (1995) [20,21] | Cross-sectional study, all subjects operated for SAH | Median 3 yr (range, 1–5) | BDI >10 | 30 | NR | Small sample size, subjects recruited at different time points following SAH, excluded subjects had worse SAH grading. | |
| Carter et al. (2000) [61] | Cross-sectional study, consecutive admissions to a tertiary medical center | Average NR (range, 1–5 yr) | ZDS ≥50 | 36 | 45.6 (SD NR) | Subjects recruited at different time points following SAH | |
| Latimer et al. (2013) [33] | Retrospective subject recruitment, all subjects had anterior circulatory area SAH | 40–45 mo | NR | NR | 6.7 | Retrospective subject recruitment, selective sample, small sample size | |
| Colledge et al. (2017) [12,13] and Gerber et al. (2016) [42] | Cross-sectional study, almost all subjects treated with clipping | 44 mo | NR | NR | 8.9±6.6 | Small sample size, subjects recruited at different time points following SAH, lack of psychiatric interview | |
| Vetkas et al. (2013) [59] | Retrospective study of a single academic center | Average 4.5 yr (range, 1–10) | GDS ≥12 | 30 | 8.4±6.9 | Retrospective study, subjects assessed at different time points following SAH | |
| Buunk et al. (2015) [30] | Cross-sectional study, all subjects had been treated by coiling or clipping | Average 4.6 yr (range, 2–10) | HADS ≥8 | 23 | 4.2±4.3 | Selective sample, subjects recruited at different time points following SAH | |
| Boerboom et al. (2017) [27] | Cross-sectional study, hospitalized subjects | Average 4.7 yr (range, NR) | HADS ≥8 | 15.2 | 3.5 (SD NR) | Selection bias, small sample size, subjects recruited at different time points following SAH | |
| Salmond et al. (2006) [48] | Cross-sectional study, method and site of recruitment not reported | Average 68 mo (range, 14–99) | NR | NR | 6.5±1.4 | Small sample size, subjects recruited at different time points following SAH | |
| Wermer et al. (2007) [38] | Cross-sectional study, all subjects treated with clipping | Average 8.9 yr (range, 2.3–18.8) | HADS >10 | 9.4 | 6.2±3.1 | Only patients treated with clipping and regained functional independence included, relative young age of the subjects, subjects recruited at different time points following SAH. | |
| von Vogelsang et al. (2013) [34] | Retrospective subject recruitment, subjects recruited from a neurosurgical clinic | Average 10.1 yr (range, 8.8–12) | HADS ≥8 | 23.5 | 4.0 (median) | Subjects recruited at different time points following SAH, no data on previous history of depression or use of antidepressants during the followup period | |
| King et al. (2009) [37] | Cross-sectional study, subjects recruited from neurosurgery clinics | NR | HADS >10 | 9 | 4.8±3.4 | A single academic center study, some eligible patients not participated, Caucasians over-represented | |
| Depression measured by interview | |||||||
| Ljunggren et al. (1985) [63] | Cross-sectional study, all subjects had treated SAH and good neurological recovery | Average 3.5 yr (range, 14 mo–7 yr) | - | 25 | NR | Attrition, sampling bias, subjects recruited at different time points following SAH, self-report of depression | |
| Hedlund et al. (2011) [62] | Prospective study, all subjects had treated SAH and good neurological outcome | 7 mo | - | 21 | NR | Attrition, sampling bias | |
SAH, subarachnoid hemorrhage; SD, standard deviation; NR, not reported; MADRS, Montgomery Åsberg Depression Rating Scale; BDI, Beck Depression Inventory; CESD, Center for Epidemiologic Studies Depression; HADS, Hospital Anxiety Depression Scale; MRI, magnetic resonance imaging; ZDS, Zung Depression Scale; GDS, Geriatric Depression Scale.