Psychosocial impact of screening for intracranial aneurysms in relatives with familial subarachnoid hemorrhage

Stroke. 2005 Apr;36(4):836-40. doi: 10.1161/01.STR.0000158906.79898.3a. Epub 2005 Mar 3.

Abstract

Background and purpose: In families with > or =2 relatives with intracranial aneurysms (IAs), screening for IAs in asymptomatic first-degree relatives is often recommended. We assessed the long-term psychosocial impact of such screening.

Methods: We identified all persons with IA (screen-positives) and matched them for age and sex with 2 controls without IA (screen-negatives) from hospital-based registers of familial IA. Persons underwent telephone interviews using questionnaires that covered the areas of psychosocial impact of screening, health-related quality of life (HRQoL), and mood. Data were compared between screen-positives and screen-negatives, and with reference populations.

Results: Overall, 105 persons from 33 families with IA were included, of whom 35 were screen-positive and 70 were screen-negative. Of the screen-positives, 12 (44%) had reduced their work and 23 (66%) had experienced changes in > or =1 area of independence, self-esteem, future outlook, or personal relationships. In contrast, only 1 (2%) screen-negative person had stopped working and 12 (17%) others had experienced changes in their self-esteem, future outlook, or relationships. Screen-positives had lower HRQoL compared with screen-negatives and the reference population, whereas both screen groups had higher mean depression scores than the reference population. Despite these effects, only 3 persons regretted participating in screening.

Conclusions: Although screening for IA is an important preventative strategy in high-risk individuals, it is associated with considerable psychosocial effects, both positive and negative. Greater awareness of such outcomes, and appropriate intervention where necessary, would appear to be a necessary component of IA screening programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety
  • Counseling
  • Depression
  • Family
  • Family Health
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / genetics
  • Intracranial Aneurysm / psychology
  • Male
  • Mass Screening / methods*
  • Mass Screening / psychology*
  • Middle Aged
  • Quality of Life
  • Registries
  • Risk
  • Risk Factors
  • Sex Factors
  • Subarachnoid Hemorrhage / diagnosis*
  • Subarachnoid Hemorrhage / psychology*
  • Surveys and Questionnaires
  • Treatment Outcome