A Literature Review of Psychosocial Comorbidities Related to Working Capacity After Aneurysmal Subarachnoid Hemorrhage.
Eleanor Turi, Yvette Conley, Ansley Grimes Stanfill
PMID 28471926WHAT IT FOUND
After aSAH, depression was most often linked to lower return-to-work rates, while cognitive, anxiety, and PTSD findings were mixed.
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Key findings
01Most included studies found depression linked to reduced working capacity after aSAH.
02Cognitive-function evidence was inconsistent: one study linked return to work to depression but not cognitive function, while other studies linked cognitive impairments to reduced working capacity.
03Anxiety and PTSD findings were mixed: moderate to severe anxiety was linked to lower return to employment in one study, but combined depression, anxiety, and PTSD scores were not linked to productive employment in another.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 10 articles, and the included studies used different psychosocial measures, different assessment times, and different return-to-work definitions, so results were hard to compare. Evidence was mixed for depression, cognitive function, anxiety, and PTSD. Many included studies did not report age, education, socioeconomic status, social support, or race and ethnicity, and the one race or ethnicity analysis had small subgroup sizes. Return to work was not only about capacity; some patients chose not to return because of retirement eligibility or changed priorities. Premorbid psychiatric history was considered in only one included study, so current psychosocial symptoms may have been mixed with prior conditions.
The easy way to misread this
Do not conclude that treating depression or anxiety will improve return to work after aSAH. The review reports associations, not tested interventions, and evidence for cognitive function, anxiety, and PTSD was mixed.