Penchev Plamen, Ivanov Kiril, Milanova-Ilieva Daniela, Gaydarski Lyubomir, Kostov Kiril, Boyadzhiev Nikola, Petrov Petar-Preslav, Mehandzhiev Patrice, Hyusein Remzi, Velchev Vladislav, Ilyov Ilko, Kuzmanov Valentin, Dzhikova Gergana, Dobreva Desislava, Toptchiyska Liliana, Dimitrova Vasilena, Petrova Victoria, Yorov Svetoslav, Stanchev Pavel, Gyulbaharov Martin, Husain Noor, Ramadanov Nikolai
Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.
Department of Pediatrics, St. George's University Hospital, 4000 Plovdiv, Bulgaria.
Brain Sci. 2025 Jul 18;15(7):764. doi: 10.3390/brainsci15070764.
Unruptured intracranial aneurysms (UIAs) can induce psychological stress, leading to anxiety, depression, and impaired quality of life (QoL). Most studies on this topic are limited by small sample sizes, cross-sectional designs, and a focus on treated rather than untreated cases, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate mental health and QoL outcomes in patients with untreated UIAs. A systematic search was conducted up to 30 November 2024 using PubMed, Scopus, and Cochrane Central for studies comparing patients with untreated UIAs to a control group. The outcomes of interest included anxiety, depression, and QoL. Statistical analysis was performed using RevMan 5.1.7 and R 4.3.1. Heterogeneity was assessed using I statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. We included five studies with 417,152 patients, of whom 85,668 (20.53%) had untreated UIAs. In the pooled analysis, patients with untreated UIAs had significantly higher anxiety levels (SMD 0.66; 95% CI [0.16; 1.17]; = 0.01; I = 76%) and lower QoL (SMD -0.82; 95% CI [-1.12; -0.53]; = 0.01; I = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; = 0.84; I = 88%) between groups. This meta-analysis indicates a potential association between untreated UIAs and increased anxiety levels and reduced QoL. Regarding depression, no significant differences were observed between groups.
未破裂颅内动脉瘤（UIAs）可引发心理压力，导致焦虑、抑郁及生活质量（QoL）受损。关于该主题的大多数研究受限于样本量小、横断面设计以及关注已治疗而非未治疗病例，使得文献中存在空白。我们旨在进行一项系统评价和荟萃分析，以评估未治疗UIAs患者的心理健康和生活质量结果。截至2024年11月30日，使用PubMed、Scopus和Cochrane Central对比较未治疗UIAs患者与对照组的研究进行了系统检索。感兴趣的结果包括焦虑、抑郁和生活质量。使用RevMan 5.1.7和R 4.3.1进行统计分析。使用I统计量和Cochrane Q检验评估异质性。风险比（RR）和标准化均值差（SMD）使用频率随机效应模型计算。我们纳入了五项研究，共417152名患者，其中85668名（20.53%）患有未治疗的UIAs。在汇总分析中，与对照组相比，未治疗UIAs患者的焦虑水平显著更高（SMD 0.66；95%CI[0.16；1.17]；P = 0.01；I² = 76%），生活质量更低（SMD -0.82；95%CI[-1.12；-0.53]；P = 0.01；I² = 56%）。然而，两组之间在抑郁方面未发现统计学显著差异（RR 0.94；95%CI[0.52；1.72]；P = 0.84；I² = 88%）。这项荟萃分析表明未治疗的UIAs与焦虑水平升高和生活质量降低之间可能存在关联。关于抑郁，两组之间未观察到显著差异。
