Risk factors for preoperative anxiety and depression in patients with unruptured intracranial aneurysms scheduled for endovascular embolization

In managing patients with unruptured intracranial aneurysms (UIAs), neurosurgeons primarily focus on assessing rupture risk and selecting appropriate treatment strategies. However, limited attention has been given to patients' preoperative psychological status and the prevalence of mental health disorders. This study aims to investigate the levels of preoperative anxiety and depression in patients scheduled for endovascular embolization for UIAs and identify potential risk factors contributing to these conditions. A total of 121 patients diagnosed with UIAs and scheduled for embolization between January 2021 and June 2023 were enrolled. Preoperative evaluations were conducted using the Hospital Anxiety and Depression Scale (HADS), with demographic and clinical data, as well as anxiety and depression scores, systematically recorded. Chi-square tests and t-tests were used for univariate analyses, and logistic regression models were constructed to identify independent risk factors associated with preoperative anxiety and depression. Among the 121 participants, 42 (34.7 %) demonstrated borderline or clinical anxiety, while 40 (33.1 %) exhibited borderline or clinical depression. Logistic regression analysis identified age (OR: 0.945, 95 % CI: 0.906-0.986, P = 0.008), type of interventional therapy (OR: 2.706, 95 % CI: 1.124-6.516, P = 0.026), and preoperative clinical symptoms (OR: 4.188, 95 % CI: 1.780-9.852, P = 0.001) as independent risk factors for significant abnormalities in HADS-Anxiety (HADS-A). For preoperative depression, higher body mass index (BMI) (OR: 1.256, 95 % CI: 1.042-1.515, P = 0.017), preoperative clinical symptoms (OR: 3.597, 95 % CI: 1.532-8.444, P = 0.003), and ASA grade (OR: 1.897, 95 % CI: 1.113-3.233, P = 0.019) were identified as independent predictors of abnormal HADS- Depression (HADS-D) scores. A substantial proportion of patients with UIAs scheduled for endovascular treatment exhibit preoperative anxiety and depression. Independent risk factors for preoperative anxiety include age, type of interventional therapy, and preoperative symptoms. For depression, preoperative symptoms, BMI, and ASA grade are key contributors. These findings underscore the importance of targeted psychological assessment and support in this patient population.