Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis

<b>Introduction:</b> 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 unt...

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Main Authors: Plamen Penchev, Kiril Ivanov, Daniela Milanova-Ilieva, Lyubomir Gaydarski, Kiril Kostov, Nikola Boyadzhiev, Petar-Preslav Petrov, Patrice Mehandzhiev, Remzi Hyusein, Vladislav Velchev, Ilko Ilyov, Valentin Kuzmanov, Gergana Dzhikova, Desislava Dobreva, Liliana Toptchiyska, Vasilena Dimitrova, Victoria Petrova, Svetoslav Yorov, Pavel Stanchev, Martin Gyulbaharov, Noor Husain, Nikolai Ramadanov
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/7/764
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author Plamen Penchev
Kiril Ivanov
Daniela Milanova-Ilieva
Lyubomir Gaydarski
Kiril Kostov
Nikola Boyadzhiev
Petar-Preslav Petrov
Patrice Mehandzhiev
Remzi Hyusein
Vladislav Velchev
Ilko Ilyov
Valentin Kuzmanov
Gergana Dzhikova
Desislava Dobreva
Liliana Toptchiyska
Vasilena Dimitrova
Victoria Petrova
Svetoslav Yorov
Pavel Stanchev
Martin Gyulbaharov
Noor Husain
Nikolai Ramadanov
author_facet Plamen Penchev
Kiril Ivanov
Daniela Milanova-Ilieva
Lyubomir Gaydarski
Kiril Kostov
Nikola Boyadzhiev
Petar-Preslav Petrov
Patrice Mehandzhiev
Remzi Hyusein
Vladislav Velchev
Ilko Ilyov
Valentin Kuzmanov
Gergana Dzhikova
Desislava Dobreva
Liliana Toptchiyska
Vasilena Dimitrova
Victoria Petrova
Svetoslav Yorov
Pavel Stanchev
Martin Gyulbaharov
Noor Husain
Nikolai Ramadanov
author_sort Plamen Penchev
collection DOAJ
description <b>Introduction:</b> 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. <b>Methods:</b> 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<sup>2</sup> statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. <b>Results:</b> 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]; <i>p</i> = 0.01; I<sup>2</sup> = 76%) and lower QoL (SMD −0.82; 95% CI [−1.12; −0.53]; <i>p</i> = 0.01; I<sup>2</sup> = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; <i>p</i> = 0.84; I<sup>2</sup> = 88%) between groups. <b>Conclusions:</b> 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.
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spelling doaj-art-4aaf4900e3f3499c9872cdf8067fe3c12025-08-20T02:45:53ZengMDPI AGBrain Sciences2076-34252025-07-0115776410.3390/brainsci15070764Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential AnalysisPlamen Penchev0Kiril Ivanov1Daniela Milanova-Ilieva2Lyubomir Gaydarski3Kiril Kostov4Nikola Boyadzhiev5Petar-Preslav Petrov6Patrice Mehandzhiev7Remzi Hyusein8Vladislav Velchev9Ilko Ilyov10Valentin Kuzmanov11Gergana Dzhikova12Desislava Dobreva13Liliana Toptchiyska14Vasilena Dimitrova15Victoria Petrova16Svetoslav Yorov17Pavel Stanchev18Martin Gyulbaharov19Noor Husain20Nikolai Ramadanov21Faculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaFaculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaDepartment of Pediatrics, St. George’s University Hospital, 4000 Plovdiv, BulgariaDepartment of Anatomy, Histology and Embryology, Medical University of Sofia, 1431 Sofia, BulgariaFaculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaFaculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaDepartment of Anatomy, Histology and Embryology, Medical University of Plovdiv, 4002 Plovdiv, BulgariaNeurosurgery Clinic, University Hospital “Pirogov”, 1606 Sofia, BulgariaFaculty of Medicine, Medical University of Sofia, 1431 Sofia, BulgariaFaculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaFaculty of Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaFaculty of Medicine, Medical University of Sofia, 1431 Sofia, BulgariaFaculty of Medicine, Medical University of Sofia, 1431 Sofia, BulgariaFaculty of Medicine, Sofia University, 1504 Sofia, BulgariaFaculty of Medicine, Sofia University, 1504 Sofia, BulgariaFaculty of Medicine, Medical University of Pleven, 5800 Pleven, BulgariaEye Clinic Den, 1000 Sofia, BulgariaDepartment of Anesthesiology, Klinik Hietzing, 1130 Wien, AustriaClinic of Endocrinology and Metabolic Diseases, St. George’s University Hospital, Medical University of Plovdiv, 4002 Plovdiv, BulgariaDepartment of Anesthesiology, Asklepios Clinic, 23843 Bad Oldesloe, GermanyDepartment of Pharmacology, Indira Gandhi Institute of Medical Sciences, Patna 800014, IndiaCenter of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg, 14770 Brandenburg an der Havel, Germany<b>Introduction:</b> 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. <b>Methods:</b> 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<sup>2</sup> statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. <b>Results:</b> 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]; <i>p</i> = 0.01; I<sup>2</sup> = 76%) and lower QoL (SMD −0.82; 95% CI [−1.12; −0.53]; <i>p</i> = 0.01; I<sup>2</sup> = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; <i>p</i> = 0.84; I<sup>2</sup> = 88%) between groups. <b>Conclusions:</b> 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.https://www.mdpi.com/2076-3425/15/7/764unruptured intracranial aneurysm (UIA)untreated UIAsdepressionanxietymental healthquality of life (QoL)
spellingShingle Plamen Penchev
Kiril Ivanov
Daniela Milanova-Ilieva
Lyubomir Gaydarski
Kiril Kostov
Nikola Boyadzhiev
Petar-Preslav Petrov
Patrice Mehandzhiev
Remzi Hyusein
Vladislav Velchev
Ilko Ilyov
Valentin Kuzmanov
Gergana Dzhikova
Desislava Dobreva
Liliana Toptchiyska
Vasilena Dimitrova
Victoria Petrova
Svetoslav Yorov
Pavel Stanchev
Martin Gyulbaharov
Noor Husain
Nikolai Ramadanov
Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis
Brain Sciences
unruptured intracranial aneurysm (UIA)
untreated UIAs
depression
anxiety
mental health
quality of life (QoL)
title Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis
title_full Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis
title_fullStr Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis
title_full_unstemmed Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis
title_short Mental Health and Quality of Life in Patients with Untreated Unruptured Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 417,152 Patients with Trial Sequential Analysis
title_sort mental health and quality of life in patients with untreated unruptured intracranial aneurysms a systematic review and meta analysis of 417 152 patients with trial sequential analysis
topic unruptured intracranial aneurysm (UIA)
untreated UIAs
depression
anxiety
mental health
quality of life (QoL)
url https://www.mdpi.com/2076-3425/15/7/764
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