Knowing you have a brain aneurysm can increase your risk of anxiety and other mental health conditions

People with aneurysms (weakened areas in the brain’s blood vessels) were at higher risk of developing a mental health condition than their peers without aneurysms. The highest risk was seen in patients younger than 40, according to research published in Heart attack.

An unruptured intracranial aneurysm occurs when the wall of a blood vessel in the brain becomes weak and bulges. This creates a risk that the blood vessel will rupture in the future and cause life-threatening bleeding in the brain.

“As a neurosurgeon who treats cerebral aneurysms, I often see people who are not undergoing surgery but still feel fear and/or anxiety about their condition before any imaging or screening tests to monitor their condition,” said study co-author Na-Rae Yang, MD, Ph.D., associate professor of neurosurgery in the department of neurosurgery at Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine in Seoul, South Korea.

“Even when medically assessed and explained that further investigation is the best solution for their aneurysm, rather than surgery, they are still concerned about the very small chance of a fatal brain hemorrhage.”

“This study did not specifically focus on brain aneurysms that were small enough not to require treatment and had a low chance of rupture. We included all diagnosed, untreated brain aneurysms that were followed,” Yang said.

“The reason for not treating and just monitoring may be that the aneurysm is small and unlikely to rupture, making treatment unnecessary. However, the decision is likely to be based on a variety of circumstances, including the patient’s overall condition, and such specific reasons were not recorded in this study group.”

Although other studies have observed patterns of stress and anxiety in patients diagnosed with an aneurysm, the researchers said this is one of the first large studies to estimate the risk of mental illness after an aneurysm diagnosis.

In this study, researchers examined data from South Korea’s National Health Information Database, which contains more than 20 years (2004 to 2024) of health data on more than 85,000 people who received care from hospitals, clinics, and pharmacies across the country. It is one of the world’s largest and most comprehensive health information databases.

More than six months after an aneurysm diagnosis, researchers compared how many people developed a mental health condition, such as anxiety, stress, depression, bipolar disorder and eating disorders, insomnia, and alcohol or drug abuse. They then compared these to the rate of mental health condition diagnoses among similar adults without an aneurysm who were receiving care for an upper respiratory infection.

The analysis took place over a 10-year period and when compared with people without aneurysms the following was found to be the case:

• People with an aneurysm were 10% more likely to be diagnosed with a mental health condition;
• the risk of mental illness was particularly high in people with an aneurysm under the age of 40; and
• In cases where a mental disorder was diagnosed by a psychiatrist, the difference was even greater, with the risk appearing to be three times higher.

“Our finding that young adults with aneurysms have a higher incidence of serious mental illness underscores the significant psychological burden for this group of patients, who may already be dealing with other stressors in their lives, such as building a career and/or starting a family,” Yang said.

“This increased rate of mental illness suggests that younger people may 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 to each individual,” Yang said.

An aneurysm may be diagnosed using imaging (such as a CT scan or MRI) to assess neurological symptoms (such as headaches or changes in vision). It may also be discovered by chance when imaging is done for another problem.

Limitations of the study include that the analysis was based on diagnostic and prescription codes in a national database, which can be inaccurate and may not reflect the nuances of individual patient care and mental health status. Additionally, the specific size and location of aneurysms were not considered.

This study design highlights a possible association, but cannot establish a causal relationship between aneurysm diagnosis and later mental health status. This study population was from South Korea, so the findings may not be consistent with populations in other countries.

Study details and design:

• The study compared the occurrence of several mental health conditions over a 10-year period in 85,438 adults (51% male; mean age 56 years) with untreated aneurysms diagnosed between 2011 and 2019, with more than 331,000 (49% male; mean age 57) without aneurysms who were treated for acute upper respiratory infections during the same period. The adults without aneurysms were matched to the diagnosis group based on age, sex, economic status, and the presence of other medical conditions.
• Mental health conditions were defined as a diagnosis of anxiety, stress, depressive disorder, bipolar disorder, eating disorder, insomnia, or alcohol or substance abuse according to the International Classification of Diseases coding database. Cases defined as diagnosed with a mental health condition plus treatment by a psychiatrist included psychotherapy with or without medication.
• Differences in the risk of mental disorders were calculated after adjusting for several factors, including age, sex, health insurance, disability, other medical conditions, smoking, alcohol use, or obesity.