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Quality of life and psychiatric sequelae following aneurysmal subarachnoid haemorrhage: does neuroendocrine dysfunction play a role?
Author(s) -
KreitschmannAndermahr Ilonka,
Poll Eva,
Hutter Bernd O.,
Reineke Andrea,
Kristes Sabine,
Gilsbach Joachim M.,
Saller Bernhard
Publication year - 2007
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2007.02821.x
Subject(s) - nottingham health profile , beck depression inventory , depression (economics) , quality of life (healthcare) , hypopituitarism , medicine , growth hormone deficiency , insulin tolerance test , distress , adrenocorticotropic hormone , psychiatry , psychology , clinical psychology , anxiety , hormone , insulin , growth hormone , insulin resistance , alternative medicine , nursing , insulin sensitivity , pathology , economics , macroeconomics
Summary Objective Patients who have sustained aneurysmal subarachnoid haemorrhage (SAH) often suffer persistent impairments in their quality of life (QoL) and psychological disturbances despite a good neurological outcome. In the light of the high prevalence of partial hypopituitarism in SAH survivors demonstrated in recent investigations, we aimed to determine whether neuroendocrine dysfunction has an impact on QoL and neurobehavioural symptoms in these patients. Design/patients QoL, depression and psychological distress were assessed in 40 SAH survivors who had undergone endocrine function testing at least 1 year after the haemorrhage. Measurements QoL was assessed using the Nottingham Health Profile (NHP), the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL‐AGHDA) and the Short Form‐36 questionnaire (SF‐36). The Beck Depression Inventory (BDI) and the Impact of Event Scale (IES) were used to evaluate depression and symptoms of current subjective distress in response to the SAH as a stressful life event, respectively. Results In a stepwise multiple regression analysis, basal cortisol level was included as the first and often only predictor for several QoL domains assessing psychological aspects of well‐being and depression whereas physical aspects of QoL were predicted primarily by neurological recovery from the SAH. Severe GH deficiency (GHD) was the first predictor for the criterion NHP subscale ‘Energy’ and highest stimulated ACTH level in the insulin tolerance test (ITT) was the first predictor for disturbed sleep as assessed with the NHP subscale ‘Sleep’. Conclusion Our results provide preliminary data that neuroendocrine disturbances contribute to disturbed QoL, depression and sleeping disturbances in SAH patients.