Marriage and Partnership Integrity After Aneurysmal Subarachnoid Hemorrhage: Small Alterations in Neurologic Status Matter Most

World Neurosurg. 2018 May:113:e161-e165. doi: 10.1016/j.wneu.2018.01.205. Epub 2018 Feb 6.

Abstract

Objective: Common sequelae of subarachnoid hemorrhage (SAH) include somatic and/or cognitive impairment. This can cause emotional stress, social tensions, and difficulties in relationships. To test our hypothesis that more severe somatic and cognitive impairments increased the likelihood of disruption of a relationship after SAH, we assessed the integrity of marriage or partnership status in a well-evaluated subset of SAH patients.

Methods: Our sample comprised 50 SAH patients who were discharged to a neurologic, in-house rehabilitation center between 2005 and 2010. Deficits on admission to the rehabilitation center were divided into 18 categories and grouped into minor and major somatic deficits, as well as cognitive deficits. Clinical outcome scores, marital/partnership status, and duration of partnership before ictus were recorded. A follow-up questionnaire after 4.3 (2012) and 8.8 (2017) years was used to assess changes in marital/partnership status. Possible predictor parameters were estimated and included in a stepdown regression analysis.

Results: In 2012, after a mean follow-up of 4.3 years, 8 of the 50 SAH patients were divorced or separated, whereas after 8.8 years only 1 additional relationship had ended. In our regression model analysis, a "short duration of relationship" before SAH and the presence of a "few minor somatic deficits" were associated with a higher likelihood of divorce or separation in the near future and remained unchanged at long-term follow-up.

Conclusion: Contrary to our hypothesis, neither the presence of severe somatic or cognitive deficits nor clinical evaluation scores reliably predicted divorce or separation after SAH.

Keywords: Aneurysmal subarachnoid hemorrhage; Divorce and separation rate; Long-term follow-up; Neurologic deficits; Neuropsychologic deficits; Partnership integrity; Rehabilitation.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / psychology*
  • Brain Damage, Chronic / etiology
  • Brain Damage, Chronic / psychology
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology
  • Divorce*
  • Emotions
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / psychology*
  • Male
  • Marriage*
  • Middle Aged
  • Spouses / psychology*
  • Subarachnoid Hemorrhage / etiology
  • Subarachnoid Hemorrhage / psychology*
  • Subarachnoid Hemorrhage / rehabilitation
  • Surveys and Questionnaires
  • Time Factors