The predictive role of family history of antipsychotic drug use in poor outcomes following aneurysmal subarachnoid hemorrhage (aSAH)

Introduction

Aneurysmal subarachnoid hemorrhage (aSAH) primarily impacts the working-age population. We have shown that 12-month survivors of aSAH from a defined population have increased use of antipsychotic drugs (APD) after aSAH.

Research question

Does familial psychiatric burden associate with the risk of APD use or having a poor outcome (mRS 3–5) after aSAH?

Material and methods

In our retrospective case-control study, we included consecutive 12-month survivors of aSAH admitted to Kuopio University Hospital with a first aSAH from 1995 to 2018 from its defined catchment population. From national health registries, data were retrieved and linked to aSAH patients, relatives, and matched population controls.

Results

Of 1347 aSAH patients (median age 54; 53 % females, median follow-up 11 years), a total of 187 (14 %) had started APD use only after the aSAH. Among 10 820 relatives, 1070 (10 %) with APD use were identified. In overall, 79 aSAH survivors with a family history of APD use or psychiatric diagnoses were not at increased risk of initiating APD use after aSAH (OR 0.79, 95 % CI 0.58–1.09). 84 (51 %) of 166 aSAH survivors with a 12-month poor outcome had a positive family history. Positive family history was an independent risk for poor outcome (OR 1.87, 95 % CI 1.28–2.73).

Discussion and conclusion

The family history of APD use or psychiatric diagnoses was not a risk factor for APD use but was an independent risk factor for poor outcome at 12 months after aSAH. This should be considered in the rehabilitation and follow-up programs.