Young survivors of severe brain hemorrhage have an elevated risk of suicide: more attention needs to be paid to psychological rehabilitation

Subarachnoid hemorrhage (SAH) is a life-threatening cerebrovascular disorder where the rupture of a bulging blood vessel, called an aneurysm, causes bleeding in the brain. Today, more and more patients with SAH survive and make a good physical recovery, but at least one third of all affected patients suffer from depression and anxiety. 

A study by researchers from HUS and University of Helsinki published in the journal Neurology investigated the risk of suicide in Finland over two decades among patients who survived SAH for at least one month after their illness. The study included more than 5,700 patients. 

The results show that SAH survivors have about 75 percent higher risk of suicide in comparison with the general Finnish population of the same age and sex. A particularly elevated risk, almost four times higher, was observed in young survivors aged 15 to 39. Moreover, the first year post-SAH appeared to be a particularly high-risk period for suicide. 

Physical recovery alone is not enough  

“It is worrying that as many as 14 percent of deaths among young SAH survivors were due to suicide. The increased risk of suicide seems to be higher following a SAH than after other cerebrovascular disorders, namely cerebral infarction and intracerebral hemorrhage,” says Aleksanteri Asikainen, Bachelor of Medicine and Ph.D. student from the University of Helsinki. 

The link between SAH and elevated risk of suicide is thought to be due to a sudden decline in physical and cognitive function, which increases psychological distress and exacerbates existing mental health disorders. In young, often healthy, individuals, the consequences of SAH are likely to be more evident in everyday life than in the general population.  

The other members of the research group, HUS Neurosurgeon and Associate Professor Miikka Korja, Professor of Genetic Epidemiology from the University of Helsinki Jaakko Kaprio, and Physician Specializing in Neurosurgery at HUS and Associate Professor Ilari Rautalin stress the need for further research to more precisely identify risk factors that influence the suicide risk and to develop rehabilitation measures to support patients. 

“Our study underlines that physical recovery alone is not enough. It is more important than ever to identify patients' psychological support needs and to intervene early in mental health issues to prevent consequences that can significantly reduce quality of life and even be life-threatening," says Rautalin, the senior author of the article. 

Research article: Asikainen A, Korja M, Kaprio J, Rautalin I. Risk of Suicide After Aneurysmal Subarachnoid Hemorrhage: A Nationwide Study 

The study was published online in the journal Neurology on January 15, 2025.  

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