cqvip:Objectives: To evaluate functioning, 18 m onths after surgery,of 49patients with good neurological recovery following aneurysm alsubarachnoid haem orrhage (SAH ), and to determ ine the extent of any im provem ents in dis- turbances of m ood,cognitive functioning,and levels of activity and participation previously observed at 9m onth follow up.M ethods: SAH patients, m atched for age, gender,and occupation with healthy control participants, com pletely quantitative m easures ofm ood (H A D S,FIES, BD I)and activity /participation (BICR O -39scales),and a briefcognitive assessmentbattery (verbalfluency,digit span,prose recall).Controls com pleted theH A D S and the BICRO -39.Results:Patients showed som e recovery of cognitive functioning,though im pairm ents of prose recall persisted.A nxiety and depression sym ptom s were higher in patients than in controls,butfewerthan 20% scored in the clinical range on any questionnaires except for RIES-Intrusive thoughts (22%);only three showed signs of full blown post-traum atic stress disorder.Alm ost half showed elevated dependence on others for dom estic activi- ties and organisation and abnorm ally low levels ofem ploy- ment.Very little variance in outcom e was predicted by dem ographic variables,neurological or cognitive im pair- m ent,prior life stress,orm ood.H owever,levels ofsocial activity and self-organisation were related to persisting fa- tigue. Conclusions: The observed decline in intrusive thoughts and avoidance over tim e is consistent with that seen after life threatening illness or traum a.The persistent reductions in independence and levels of em ploym ent m ay in som e casesreflectconsidered lifestyle adjustm ents rather than adverse and unwanted changes butin others indicate a need forfocused rehabilitation.
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