Socioeconomic Status Not Linked to Anxiety, Depression After Aneurysmal Subarachnoid Hemorrhage

Socioeconomic status is not associated with anxiety or depression in survivors of aneurysmal subarachnoid hemorrhage, according to findings published in the Journal of Clinical Neuroscience.

Researchers conducted a retrospective study of a prospectively collected aneurysmal subarachnoid hemorrhage cohort to evaluate the effect of socioeconomic status on anxiety and depression at discharge. The researchers also measured functional outcome post-discharge using the modified Rankin Scale. Participants with confirmed aneurysmal etiology and no prior history of anxiety or depression were included. Median household income, split into quintiles, was determined by US census data. Chi-square, Wilcoxon, Kruskal-Willis tests, and logistic and binary regression models were employed for statistical analysis.

A total of 342 aneurysmal subarachnoid hemorrhage survivors were included in the study, of whom the mean (SD) age was 57 (13.7) years, 63% were women, and 71% were White. A total of 307 screening tests for anxiety (n=174) and depression (n=133) were performed in 186 patients.

More than half (62%) of patients screened for anxiety had anxiety at discharge. Anxiety was more likely to occur in women compared with men (70% vs 50%; P =.012). Further, although anxiety was numerically higher in patients from the lowest and highest household income quintiles, this difference was not statistically significant (P =.35).

Among patients screened for depression, 50% had depression at discharge. Depression was more common in men than women (59% vs 44%; P =.09), and less common in patients from the lowest and highest household income quintiles (P =.14), though these differences did not reach statistical significance. In addition, those who used tobacco prior to admission were more likely to have depression at discharge compared with non-users (21% vs 6%; P =.01).

Multivariable analysis showed that a higher modified Rankin Scale score at discharge was independently associated with depression at discharge (odds ratio [OR], 1.29 per modified Rankin Scale point increase [95% CI, 1.01-1.64]; P =.037). Tobacco use prior to hospitalization was also a significant predictor of depression at discharge (OR, 4.58 [95% CI, 1.38-15.2]; P =.013).

Moreover, independent of other predictors, the presence of depression (OR, 2.37 [95% CI, 1.23-4.54]; P =.01) or anxiety (OR, 2.39 [95% CI, 1.31-4.34]; P =.004) at discharge was associated with higher modified Rankin Scale score 3 months post-discharge. However, prescription of an antidepressant showed no independent association with 3-month post-discharge functional outcomes.

Study limitations include a single-center retrospective model and limited socioeconomic status data.

“Although [socioeconomic status] factors were not associated with anxiety and depression in survivors of [aneurysmal subarachnoid hemorrhage], larger prospective studies are needed to explore any potential associations,” the authors wrote.