Impacto da reserva cognitiva na sintomatologia depressiva e ansiosa e na funcionalidade em indivíduos com hemorragia subaracnoideia não-traumática

Abstract

Theoretical Framework: It is documented that Non-Traumatic Subarachnoid Hemorrhage due to aneurysm rupture (aHSA) leads to emotional sequelae, such as the incidence of depressive and anxious symptoms, as well as functional impairments. This dissertation aimed to investigate the impact of Cognitive Reserve (CR), measured through proxies such as education, occupational status, social support, and premorbid IQ, on depressive and anxious symptoms, as well as functionality, in individuals who suffered from non-traumatic aneurysmal subarachnoid hemorrhage (aHSA). Methodology: The convenience sample of this cross-sectional study consisted of 10 participants aged between 40 and 85 years. After a brief clinical interview, the MoCa, TeLPI, SAHOT, EPS, HADS, and BDI-II were administered. Spearman correlation coefficient tests were conducted, and a psychometric analysis of the SAHOT scale was performed. Results: Significant correlations were found between education and anxiety (positive), and between premorbid IQ and dysfunctionality (positive), correlations that did not align with the literature. Additionally, the small sample size in this study (n=10) may have contributed to the lack of significant results. Through qualitative analysis, it was observed that premorbid IQ and social support can act as protective factors in individuals with lower education and less complex professional occupations. Additionally, in cases of greater clinical severity of the hemorrhage and the occurrence of complications such as vasospasm, the protective effect of the proxies may be attenuated. In participants with higher education and more complex occupations, it was noted that social support protects against depressive and anxious symptoms. The Portuguese version of SAHOT showed no floor or ceiling effects, demonstrated convergent validity, and had sufficient internal consistency across all domains and for the total score. Conclusion: The analyses suggest that cognitive reserve plays a protective role, but this effect can be modulated by the severity of the hemorrhage and the presence of complications, such as vasospasm. The results emphasize the need for personalized approaches and the consideration of multiple variables in post-aHSA management.

Date of Award	23 Jan 2025
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Maria Vânia Silva Nunes (Supervisor)