Analysis of Influencing Factors of Anxiety and Depression in Patients with Intracranial Dural Arteriovenous Fistulas before Endovascular Treatment: A Retrospective Study

Abstract

Background: Typical treatment of dural arteriovenous fistula (DAVF) emphasizes clinical procedures such as surgery, radiotherapy, and endovascular treatment. However, external factors of adverse psychological emotions in patients with DAVF before treatment have not yet been evaluated in a multicenter study. Objectives: This study aimed to fill the research gap regarding the effects of factors by evaluating the anxiety and depression status among patients with DAVF before and after endovascular treatment and identify factors influencing the development of anxiety and depression before their endovascular treatment. Methods: This retrospective study included 168 DAVF patients treated at two independent neurosurgical medical centers from December 2012 to December 2022. The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were assessed before and after endovascular treatment. Demographic and clinical data were also collected. Statistical tests were performed to calculate the proportion of DAVF patients with anxiety and depression. A multivariate analysis was conducted to identify independent risk factors for anxiety and depression in patients with DAVF before endovascular treatment. Results: A significant decrease in the percentage of patients with anxiety and depression was observed in patients after endovascular treatment compared with before treatment. Patients with DAVF who were at a higher risk for anxiety and depression were females had multiple visits, comorbid conditions, and a lower economic status and were presented with symptoms. Conclusion: After endovascular treatment, the anxiety or depression symptoms of DAVF patients significantly improved. Our findings provide additional evidence to support the role of intravascular treatment in improved DAVF patients’ psychological outcomes.