The effects of neuroticism, depression and passive coping style on the discrepancy between cognitive complaints and cognitive outcome after aneurysmal subarachnoid hemorrhage.

Abstract

Abstract thesis BACKGROUND: Depression and personality characteristics may be contributing factors to the discrepancy between cognitive complaints and cognitive outcome after aneurysmal Subarachnoid Hemorrhage (aSAH). The goal of this study is to determine the independent predictive values of cognitive outcome, depression, neuroticism and passive coping to cognitive complaints after aSAH. METHODS: For 267 aSAH patients, cognitive complaints were assessed using the Checklist for Cognitive and Emotional consequences following stroke (CLCE-24). Cognitive outcome was assessed by neuropsychological assessment, and levels of depression, neuroticism and passive coping were measured through questionnaires. The predictive value of the possible predictors was calculated using a hierarchical multiple linear regression, the effects neuroticism and passive coping were assessed in different regression models. RESULTS: Cognitive complaints and deficits in cognitive functioning were highly prevalent (±90%). 11.7% showed signs of clinical depression. Neuroticism (β=.306, p=.001) and passive coping (β=.313, p=.014) were significant predictors of cognitive complaints, however after adding depression to the models, their contribution became nonsignificant and depression became the only significant predictor (β=.569, p<.001). The final model revealed a total explained variance of cognitive complaints of 39.5% with F(5, 59) = 7.716, p<.001, adjusted R²=.344. DISCUSSION: Traits of neuroticism and passive coping style are associated with cognitive complaints after aSAH. This association can however be explained by symptoms of depression, which are more frequently present in patients with traits of neuroticism and passive coping style, making symptoms of depression a better predictor for subjective cognitive complaints after aSAH. It is therefore important to take levels of depression into account in the rehabilitation process.