Anxiety and mood disorders are associated with greater healthcare and procedural utilization in idiopathic intracranial hypertension

Abstract

Background and purpose Anxiety and mood disorders (AMD) are common in idiopathic intracranial hypertension (IIH), but their association with procedural treatment and healthcare utilization is unclear. We evaluated utilization among patients with AMD documented before or shortly after IIH. Methods Using the TriNetX US Collaborative Network, we identified adults diagnosed with IIH on or after January 1, 2016. The primary analysis compared patients with AMD documented on or before IIH with those without AMD; the sensitivity analysis compared patients with a first AMD diagnosis within 1 month after IIH with those without AMD before or during that month. Each analysis used separate 1:1 propensity-score matching. 5-year outcomes were assessed using Kaplan-Meier methods and Cox regression. Results The primary analysis included 38 117 matched patients per group. At 5 years, patients with AMD had higher rates of cerebrospinal fluid shunting (5.86% vs 4.62%; HR 1.168), transverse venous sinus stenting (1.40% vs 1.09%; HR 1.236), either procedure (7.12% vs 5.61%; HR 1.178), inpatient admission (45.63% vs 36.88%; HR 1.214), and emergency department visits (56.57% vs 42.57%; HR 1.519), but lower mortality (7.70% vs 9.67%; HR 0.725). The sensitivity analysis included 8949 matched patients per group and showed the same pattern among patients with AMD newly diagnosed within 1 month after IIH. Conclusions AMD documented before or shortly after IIH was associated with greater procedural and healthcare utilization. These observational findings describe patterns of care but do not establish that AMD causes greater IIH severity or procedural need.