Depression after aneurysmal subarachnoid hemorrhage: development of a screening tool and discharge user interface

Stefan W. Koester, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Brandon K. Hoglund, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Joelle N. Hartke, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Robert F. Rudy, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Ashutosh P. Jadhav, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Andrew F. Ducruet, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Felipe C. Albuquerque, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Joshua S. Catapano, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Laura A. Snyder, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA.
Michael T. Lawton, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013, USA. Neuropub@barrowneuro.org.

Document Type

Article

Abstract

BACKGROUND: A method for identification of chronic depression after aneurysmal subarachnoid hemorrhage (aSAH), risk stratification, and counseling is needed. This study aimed to develop a scoring system for post-aSAH depression and a user interface to supplement discharge counseling for patients. METHODS: Based on a published prediction model for posttreatment depression risk among aSAH patients, a scale was developed using the beta coefficients of the final predictive model. The 5-point scale was based on 4 characteristics: tobacco use (2 points), chronic obstructive pulmonary disease (1 point), diabetes (1 point), and nonsaccular aneurysm type (1 point). A score of 1 was defined as low risk, a score of 2 or 3 was defined as medium risk, and a score of 4 or 5 was defined as high risk. The scale was then validated in a cohort of 514 patients treated at a single center. An interactive application was developed. RESULTS: The rate of posttreatment depression among aSAH patients was 29.6% (152 of 514). The low-risk group had a nonsignificant increase in depression risk (relative risk [RR] [95% CI] = 0.89 [0.59-1.33], p = 0.71) compared with those with a score of 0. Significant increases in depression risk were found in the medium-risk (RR [95% CI] = 1.78 [1.34-2.37], p < 0.001) and high-risk (RR [95% CI] = 2.29 [1.28-4.09], p < 0.001) groups. CONCLUSIONS: A substantial percentage of patients in our cohort experienced major depressive disorder symptoms after aSAH treatment. An easy-to-use prediction and risk stratification tool for posttreatment depression among aSAH patients is available.

Medical Subject Headings

Humans; Subarachnoid Hemorrhage (psychology, complications); Male; Female; Middle Aged; Aged; Depression (diagnosis, etiology); Patient Discharge; Adult; Risk Factors; Mass Screening (methods)

Publication Date

6-24-2025

Publication Title

Acta neurochirurgica

E-ISSN

0942-0940

Volume

167

Issue

1

First Page

176

PubMed ID

40553207

Digital Object Identifier (DOI)

10.1007/s00701-025-06567-8

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