Astheno-emotional disorder after aneurysmal SAH: reliability, symptomatology and relation to outcome

Objectives - Neuropsychiatric symptoms commonly found after aneurysmal SAH are covered in the astheno-emotional disorder (AED) of Lindqvist & Malmgren s diagnostic system for organic psychiatry. This study aims to describe the reliability and symptomatology of AED and its relationship with social out come. Material and methods - Patients referred due to aneurysmal SAH (n = 7 8) were assessed after 1-6 months for AED inter-rater reliability (n = 36) and after 12 months for AED severity grade, symptomatology and Glasgow Outc ome Scale (GOS) (n = 63). Results - There was no systematic error in diagno sing and grading AED, and the agreement was 85% and 67% respectively (kappa = 0.65 and 0.52). Fatigability, concentration difficulties and memory diff iculties were the most frequent symptoms of AED. The relationship between A ED and "moderate disability" of GOS was highly significant (P <0.00006). Co nclusions - AED affects social outcome, and can be diagnosed with high reli ability even without neuropsychological testing. Use of the AED diagnosis f or evaluation of organic mental symptoms is encouraged.