Abstract
INTRODUCTION: Unruptured intracranial aneurysms (UIAs) and aneurysmal subarachnoid hemorrhage (aSAH) pose not only neurological but also psychological and cognitive challenges. This study aimed to compare patients with UIA and aSAH and explore how psychological symptoms relate to their quality of life (QoL). METHODS: Between May 2023 and May 2025, 128 patients (aged 31-79, M = 53.9, SD = 7.24) were enrolled: 63 with aSAH and 65 with UIA. All aSAH patients had favourable neurological outcomes (modified Rankin Scale score of 0 or 1). Assessment included the Montreal Cognitive Assessment (MoCA), State-Trait Anxiety Inventory - Trait (STAI-T), Beck Depression Inventory - Short Form (BDI-SF), Athens Insomnia Scale (AIS), Toronto Alexithymia Scale (TAS-20), and WHOQOL-BREF. RESULTS: There were no significant psychological or cognitive differences between the aSAH and UIA groups; thus, they were analysed together. Compared to normative data, patients showed reduced cognitive performance and elevated depressive symptoms. Psychological well-being was the most affected QoL domain. All psychological variables negatively correlated with QoL, with anxiety, depression, and sleep disturbances emerging as significant predictors in linear regression. DISCUSSION: Our results suggest that emotional and sleep-related symptoms have a more substantial impact on QoL than cognitive impairment. The lack of group differences implies that psychological vulnerability may already be present before aneurysm rupture, underlining the need for early intervention. CONCLUSION: The knowledge of having an aneurysm alone places a significant psychological burden on patients even without SAH, affecting cognitive and psychological well-being and quality of life. Therefore, psychological follow-up and care of patients diagnosed with intracranial aneurysms should be a priority. TRIAL REGISTRATION: Not applicable because the health-related intervention was not conducted in this study.