To determine the association of socioeconomic status (SES) with anxiety and depression in survivors of aneurysmal subarachnoid hemorrhage (aSAH).

The relationship between SES and mental health outcomes in aSAH patients has not been well explored. We investigated the impact of SES on anxiety and depression outcomes at discharge.

We performed a retrospective study on a prospectively collected cohort of aSAH patients admitted to an academic center from 2016 to 2024. Data on median household income by zip code areas (5-year estimates for 2022) were taken from the US census. Anxiety and Depression screening is performed in survivors of aSAH at discharge, as recommended by the guidelines. Univariable and multivariable logistic regression analyses were used to assess the associations between SES components and outcomes.

We reviewed 450 cases of aSAH and included 342 survivors with mean age 57 years (SD 13.7), 63% female and 71% white. Anxiety and depression screenings were performed on 171 and 132 patients respectively, who were able to communicate at discharge. Anxiety was more common in females (68% vs 50%; p=0.018) but depression was non-significantly more common in males (59% vs 44%, p=0.10). Although there was no difference in age, race, religion, insurance status and aSAH related clinical and radiographic features between patients with anxiety or depression and those without, depression was non-significantly less common in patients from zip codes from the lowest and highest household income quintiles. Conversely, anxiety was non-significantly more common in patients from the lowest and highest household income quintiles.

SES factors may affect the risk of anxiety and depression in survivors of aSAH. Larger multicenter prospective studies are needed to explore any potential associations.