Resilience in good outcome patients with fatigue after aneurysmal subarachnoid hemorrhage

Resilience is a psychological process that encompasses various facets of personality traits, behaviour, as well as coping, and it enhances the adjustment to adversities faced. Although a lot of interest has been devoted to the protective effects of resilience in handling affective disorders, little is known about the relationship between resilience and chronic fatigue, which is a common and potentially disabling sequel in survivors of aneurysmal subarachnoid hemorrhage (aSAH). Ninety-six good outcome patients with chronic post-aSAH fatigue answered the Resilience Scale for Adults (RSA) which assesses 6 distinct aspects of resilience. They also answered the Fatigue Severity Scale (FSS), Mental Fatigue Scale (MFS), Beck Depression Inventory (BDI-II), Beck's Anxiety Inventory (BAI), and the Brief COPE. The RSA scores were related to fatigue, emotional burden and coping. The prevailing resilience factor was "Social Resources". Patients with the highest scores for fatigue and emotional symptoms scored significantly lower for the factors "Perception of Self", "Perception of Future" and "Family Cohesion". Patients with clinically significant depression scored low across most RSA factors, with the weakest factors being "Perception of Self" and "Perception of Future". Resilience factors were positively associated with adaptive problem focused coping strategies, and in particular with the emotional coping strategy "Acceptance", whereas they correlated negatively with maladaptive avoidant coping. strategies. There is a close interaction between high resilience, adaptive coping strategies and lower burden of chronic fatigue and emotional symptoms.