Table 3.
Studies of associations between clinical features and complications of subarachnoid hemorrhage, comorbidities, biomarkers, and depression
| Study | Risk factors | Associations with depression | Confounders controlled using multivariate analysis | |
|---|---|---|---|---|
| Demographic characteristics | ||||
| Hütter et al. (1995) [20] | Age | No association | No | |
| Morris et al. (2004) [40] | Age | No association | No | |
| Caeiro et al. (2011) [54] | Sex | Female sex (P=0.003) | No | |
| Preiss et al. (2007) [46] | Sex | No association | No | |
| von Vogelsang et al. (2013) [34] | Sex | No association | No | |
| Kreiter et al. (2013) [53] | Ethnicity | Non-white ethnicity, (OR, 2.7; 95% Cl, 1.4–5.4; P=0.005); non-fluency in English (OR, 3.7; 95% Cl, 1.7–8.2; P=0.001) | No | |
| Brand et al. (2015) [65] | Education | No association | No | |
| Premorbid conditions | ||||
| Caeiro et al. (2011) [54] | Psychiatric history | Past mood disorder (P=0.007), absence of pre-SAH dementia (P=0.05) | No | |
| Kreiter et al. (2013) [53] | Psychiatric history | History of depression (OR, 3.1; 95% Cl, 1.2–7.6; P=0.016) | Yes | |
| Hedlund et al. (2011) [62] | Psychiatric history | Lifetime affective disorder (OR, 11.9; 95% Cl, 3.0–46, P=0.001), anxiety disorder (OR, 6.5; 95% Cl, 1.6–26; P=0.008), substance use disorder (OR, 9.8; 95% Cl, 1.5–66; P=0.019), or any psychiatric disorders (OR, 14.1; 95% Cl, 3.0–47; P=0.001) | Yes | |
| Kreiter et al. (2013) [53] | Psychiatric history | Nicotine use (OR, 2.4; 95% Cl, 1.3–4.5; P=0.006) | Yes | |
| Ackermark et al. (2017) [41] | Premorbid personality traits | Passive coping was correlated with depressive symptoms (ρ=0.576, P<0.001). | Yes | |
| Clinical features and complications of SAH | ||||
| Hütter et al. (1995) [20,21] | Neurological outcomes | No association | No | |
| Morris et al. (2004) [40] | Neurological outcomes | No association | No | |
| Bründl et al. (2018) [58] | subtypes of SAH | Depression symptoms were more common in aneurysmal SAH patients treated with microsurgury and endovascular aneurysm occlusion than those with perimensencephalic SAH (P=0.035 and P=0.016 respectively). | No | |
| Boerboom et al. (2014) [22] | subtypes of SAH | Aneurysmal SAH patients had a higher mean CESD score (13.9±8.7 vs. 5.0±4.9, P=0.006) and higher rate of depression (44.4% vs. 0%, P=0.035) than perimensencephalic SAH. | No | |
| von Vogelsang et al. (2013) [34] | Location of aneurysms | Rupture of posterior circulation aneurysms, compared to anterior circulation aneurysums, was related to a higher level of depression (P=0.036). | No | |
| Hütter et al. (1995) [20] | subtypes of SAH | No association | No | |
| Kreiter et al. (2013) [53] | Infarctions | SAH-related infarction predicted depression (OR, 2.1; 95% Cl, 1.1–4.0; P=0.026). | Yes | |
| Hütter et al. (1995) [21] | Infarctions | Parietal and/or frontal infarcts were negatively correlated with depression (n=58; F=5.03, t=2.57, P=0.03). | No | |
| Bellebaum et al. (2004) [49] | SAH treatment | Patients treated with clips had more depressive symptoms than those treated with coils (U=73.50; P=0.039). | No | |
| Preiss et al. (2007) [46] | SAH treatment | No difference between clips and coils | No | |
| Fontanella et al. (2003) [50] | SAH treatment | No difference between clips and coils | No | |
| Latimer et al. (2013) [33] | SAH treatment | No difference between clips and coils | No | |
| Comorbidities | ||||
| Boerboom et al. (2017) [27] | Cognitive function | Self-rated cognitive function (r=0.372) and memory function (r=–0.427) | No | |
| Fertl et al. (1999) [51] | Cognitive function | Cognitive impairment (P<0.01) | No | |
| Passier et al. (2010) [14] | Cognitive function | depressive symptoms predicted cognitive complaints (β=0.40, P<0.001) | Yes | |
| Wong et al. (2012) [57] | Cognitive function | MoCA (Kendall’s tau b coefficient 0.191; P=0.027) and MMSE (Kendall’s tau b coefficient 0.198; P=0.024) | No | |
| Brand et al. (2015) [65] | Cognitive function | No association | No | |
| Tölli et al. (2018) [25] | Cognitive function | No association | No | |
| Orbo et al. (2008) [45] | Cognitive function | No association | No | |
| Ljunggren et al. (1985) [63] | Fatigue | Correlated with depressive symptoms (r=0.597) | No | |
| Buunk et al. (2018) [26] | Fatigue | Correlated with depressive symptoms (r=0.58) | No | |
| Hütter et al. (2014) [43] | Post-traumatic stress disorder | Severity of depression was correlated with scores on the IES avoidance and intrusion subscales (r=0.45 and r=0.52, respectively). | No | |
| Gill et al. (2015) [31] | Post-traumatic stress disorder | Higher rate of depression predicted greater symptoms of post-traumatic stress disorder (β=0.38, t=5.74, P<0.001). | Yes | |
| Boerboom et al. (2017) [27] | Physical comorbidity | Correlated with depressive symptoms (r=0.419) | No | |
| Functioning | ||||
| Ackermark et al. (2017) [41] | Disability | Correlated with depressive symptoms (ρ=–0.343, P=0.001) | Yes | |
| Fertl et al. (1999) [51] | Reduced working capacity | Depression was more frequent in patients with reduced working capacity (P<0.001). | No | |
| Biomarkers | ||||
| Colledge et al. (2017) [13] | Hair cortisol level | Correlated with depressive symptoms (r=0.56) | No | |
| Kreitschmann-Andermahr et al. (2007) [47] | Basal cortisol value | Correlated with (r=–0.56, P<0.01) and predicted depression (R2=0.30) | Yes | |
| Alfieri et al. (2008) [17] | APOE-ε4 | Correlated with depressive symptoms (P<0.05) | No | |
OR, odds ratio; SAH, subarachnoid hemorrhage; CESD, Center for Epidemiologic Studies Depression; MoCA, Montreal Cognitive Assessment; MMSE, Mini-Mental State Examination; IES, Impact of Event Scale; APOE-ε4, apolipoprotein E ε4.