Neuroendokrine Funktionsstörungen, gesundheitsbezogene Lebensqualität und psychiatrische Folgeerkrankungen im chronischen Stadium nach aneurysmatischer Subarachnoidalblutung

Patients who have sustained aneurysmal subarachnoid haemorrhage (SAH) often suffer persistent impairments in their quality of life (QoL) and psychiatric disturbances despite a good neurological outcome. In the light of the high prevalence of partial hyptopituitarism in SAH survivors and the frequently observed psychosocial discorders, this work aims to determine whether neuroendocrine dysfunction has an impact on QoL and the prevalence of psychiatric disturbances in these patients. Neuroendocrine dysfunction, QoL, depression and psychological distress were assessed in 40 SAH survivors with a good neurological outcome. Pituitary function was tested using a combined TRH-LHRH-arginine test and the insulin tolerance test (ITT). QoL was assessed using the Short Form-36 questionnaire (SF-36), the Nottingham Health Profile (NHP) and the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA). The Beck Depression Inventory (BDI) and the Impact of Event Scale (IES) were used to evaluate depression and symptoms of current subjective distress response to the SAH as a stressful life event, respectively. Different forms of pituitary deficiency were diagnosed in 22 of the 40 patients. In view of QoL predominantly psychosocial aspects were reduced. Furthermore an increased prevalence of depression and symptoms of subjective distress were identified. In a stepwise multiple regression analysis, basal cortisol level was included as the first and often only predictor particularly for psychological aspects of QoL and depression whereas physical domains of QoL were predicted primarily by neurological recovery from the SAH, assessed using the Glasgow Outcome Scale (GOS). Severe GH deficiency was the first predictor for the criterion NHP subscale “Energy” and highest stimulated ACTH level in the ITT was the first predictor for disturbed sleep as assessed with the NHP subscale “Sleep”. The results of this work provide preliminary data that neuroendocrine disturbances contribute to QoL and demonstrate an increased prevalence of depression and subjective distress in SAH patients.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2008

Author dc:creator

• Kristes, Sabine

Contributors dc:contributor

• Gilsbach, Joachim M.

• info:eu-repo/classification/ddc/610
• Medizin
• Subarachnoidalblutung
• Neuroendokrine Funktionsstörung
• Lebensqualität
• psychiatrische Folgeerkrankungen
• subarachnoid haemorrhage
• neuroendocrine dysfunction
• quality of life
• psychiatric sequelae

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-112596%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A50032