Quality of Life, Anxiety, and Depression in Patients With an Untreated Intracranial Aneurysm or Arteriovenous Malformation

Abstract

Background and Purpose-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. Methods-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 ) 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. Results-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. Conclusions-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.

Inadequate Website Disclosure of Surgical Outcome of Intracranial Aneurysms-Survey of 1225 Sites in Japan-

“…It is easy to spread biased information for commercial purposes on the Internet. 30) The present study revealed that only 2.6% of 1225 institutions in Japan disclosed outcome data of treatment for unruptured intracranial aneurysms on websites. This number is lower than we had expected when we launched this study.…”

“…Indeed, many papers report that the Internet is becoming the most important source of information for patients. 1,28,30,33) On the other hand, outcome disclosure is not easy from the viewpoint of hospitals and physicians that are subject to disclose information to the public. Complicated problems arise when information about medical outcomes are disclosed.…”

“…1,23,28,30,33) This medium directly provides anonymous access to the most recent information anywhere at anytime. For general information on health care such as definition of diseases and explanation of treatments, disclosure is comparatively simple and straightforward.…”

Results of Endovascular Treatment in 295 Elderly Patients with Unruptured Cerebral Aneurysms in Comparison with Non-elderly Patients in a Single Institution

“…In elderly patients, this anxiety is more marked, and many patients report this anxiety as mental stress. [13][14][15] SAH with ruptured cerebral aneurysm more frequently leads to a serious condition in elderly patients, making it difficult to maintain pretreatment ADLs after rupture; 12) in addition to the characteristics of SAH, protracted-bedrest-related cognitive dysfunction or disuse progression 16,17) may affect subsequent recovery in elderly patients. [18][19][20] In many cases, the treatment indication for unruptured cerebral aneurysms in non-elderly patients is evaluated based on the location, size, and shape of aneurysms.…”

Unruptured Intracranial Aneurysms: Current Perspectives on the Origin and Natural Course, and Quest for Standards in the Management Strategy

“…Quality of life (QOL) score was also analyzed in several outcome studies. 27,39,44) Some reported significant decline of QOL long time after aneurysm repair. However, preoperative anxiety was relieved by the repair of the aneurysm and QOL also improved.…”