Quality of life, anxiety, and depression in patients with an untreated intracranial aneurysm or arteriovenous malformation

• Published in: Stroke (1970) Vol. 33; no. 2; pp. 440 - 443
• Main Authors: VAN DER SCHAAF, Irene C, BRILSTRA, Eva H, RINKEL, Gabriel J. E, BOSSUYT, Patrick M, VAN GIJN, J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.02.2002; American Heart Association, Inc
• Subjects: Anxiety; Anxiety - diagnosis; Anxiety - psychology; Biological and medical sciences; Comorbidity; Depression - diagnosis; Depression - psychology; Female; Humans; Intracranial Aneurysm - diagnosis; Intracranial Aneurysm - epidemiology; Intracranial Aneurysm - psychology; Intracranial Arteriovenous Malformations - diagnosis; Intracranial Arteriovenous Malformations - epidemiology; Intracranial Arteriovenous Malformations - psychology; Male; Manifest Anxiety Scale; Medical sciences; Middle Aged; Netherlands - epidemiology; Neurology; Psychology; Quality of Life - psychology; Retrospective Studies; Sickness Impact Profile; Surveys and Questionnaires; Vascular diseases and vascular malformations of the nervous system; Netherlands; Mood disorder; Human; Intracranial; Nervous system diseases; Aneurysm; Cardiovascular disease; Depression; Psychometrics; Psychosocial factor; Congenital disease; Cerebral disorder; Venous disease; Quality of life; Arterial disease; Vascular disease; Central nervous system disease; Evolution; Anxiety; Cerebrovascular disease; Arteriovenous malformation
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/hs0202.102335

The objective of this study was to assess the health-related quality of life and symptoms of anxiety and depression in patients who are aware of the presence of a patent aneurysm or arteriovenous malformation. Participants were retrospectively identified and invited to participate in the study; consenting participants were interviewed in a face-to-face setting by means of 2 questionnaires assessing health-related quality of life (Sickness Impact Profile [SIP] and the MOS Short Form-36 [SF-36]) and psychological state (Hospital Anxiety and Depression Scale [HADS]). We used Student's t test statistics to compare the scores of the study population with the scores of reference populations. We identified 21 patients, of whom 9 had an aneurysm and 12 had an arteriovenous malformation. Compared with the reference population, these patients had a reduced quality of life for sleep and rest (difference of SIP means, 6.8; 95% CI, 3.1 to 10.5), emotional behavior (10.1; 95% CI, 5.7 to 14.6), mobility (5.4; 95% CI, 2.1 to 8.7), social interactions (5.3; 95% CI, 1.6 to 8.9), and alertness behavior (11.9; 95% CI, 6.2 to 17.5). The SIP psychosocial subscore (7.1; 95% CI, 3.9 to 10.2) and total SIP score (4.7; 95% CI, 2.2 to 7.2) were also significantly impaired. For the SF-36 domains, social functioning was significantly decreased compared with the reference population (8.9; 95% CI, 0.1 to 17.7). HADS scores for depression were similar for patients and the reference population. Our study shows that knowledge of harboring an unoccluded untreated intracranial aneurysm or arteriovenous malformation reduces quality of life, most prominently on the psychosocial domains, without leading to substantially raised levels of anxiety and depression.