Among brain aneurysm patients, the risk of developing a mental health condition has been found to be higher as compared to among peers without an aneurysm—and the highest risk was seen in patients younger than 40 years of age. These are among key findings of new research published recently in the journal Stroke.
“As a neurosurgeon who treats cerebral aneurysms, I often see people who do not undergo surgery yet feel fear and/or anxiety about their condition before each imaging or screening test to monitor their condition,” said study co-author Na-Rae Yang (Ewha Womans University College of Medicine, Seoul, South Korea). “Even when it is medically judged and explained that follow-up observation is the best course for their aneurysm rather than surgery, they still worry about the very slim chance of developing a fatal brain bleed.
“This study did not specifically target brain aneurysms that were small enough not to require treatment and had a low probability of rupture. We included all diagnosed, untreated brain aneurysms that were being followed. The reason for not treating and only following up may be that the aneurysm is small and unlikely to rupture, making treatment unnecessary. However, the decision is likely based on various circumstances, including the patient’s overall condition, and such specific reasons were not captured in this study group.”
While other studies have observed patterns of stress and anxiety in patients living with an aneurysm diagnosis, the researchers note that this is one of the first large studies to estimate the risk of a mental health condition after aneurysm diagnosis.
In the study, Yang and colleagues examined data from the National Health Information Database in South Korea, which includes over 20 years (2004–2024) of health data for more than 85,000 people who received care from hospitals, clinics and pharmacies throughout the country. The database is described as being one of the world’s largest and most comprehensive health information databases.
More than six months after diagnosis of their aneurysm, study researchers compared how many people developed a mental health condition—such as anxiety, stress, depression, bipolar and eating disorders, insomnia, and alcohol or drug misuse. They then compared them to the rate of mental health condition diagnoses among similar adults without aneurysms who received care for an upper respiratory infection.
The analysis took place over a 10-year period and, comparing patients with versus without an aneurysm, produced the following results:
- People with an aneurysm were 10% more likely to be diagnosed with a mental health condition
- The risk of a mental health condition was particularly pronounced in aneurysm patients under the age of 40
- In cases where a mental health condition was diagnosed by a psychiatrist, the difference was even greater, showing a three-fold increased risk
“Our finding of a higher rate of a severe mental health condition in younger adults with aneurysm underscores the significant psychological burden for this group of patients who may already be dealing with other life stressors, such as building their career and/or raising a family,” Yang stated. “This elevated rate of mental health conditions suggests that younger people might be particularly vulnerable, highlighting the need for targeted mental health support and interventions for this age group. This includes providing clear explanations and tailoring treatment decisions for each person.”
Limitations of Yang and colleagues’ study include the fact that the analysis was based on diagnostic and prescription codes in a national database, which may be imprecise and may not reflect the nuances of individual patient care and mental health status. In addition, the specific size and location of aneurysms were not considered. The authors have further noted that the study design highlights a possible association but cannot establish a cause-and-effect relationship between an aneurysm diagnosis and later mental health status. Finally, this study population was from South Korea, so the findings may not be consistent with populations in other countries.
