A Systematic Review of Neuropsychiatric Symptoms in Idiopathic Intracranial Hypertension

Abstract

Background

There is limited characterization of neuropsychiatric symptoms (NPS) in patients with idiopathic intracranial hypertension (IIH). Along with commonly presenting symptoms of IIH, including headache and papilledema, NPS may have a significant impact on IIH outcomes.

Objective

We completed a systematic review of the literature to characterize the most common noncognitive NPS in IIH patients and examine associations between noncognitive NPS and IIH outcomes.

Methods

A Preferred Reporting Items for Systemic Reviews and Meta-Analysis compliant literature search was conducted in Ovid Medline, PubMed, PsycInfo, Embase, Web of Science, Cochrane, CINAHL, and Scopus databases. The initial query yielded 1688 unique articles. These articles were narrowed to those including empirical analyses of noncognitive NPS in adult patients with IIH.

Results

A final cohort of eight articles comprised 724 individuals with IIH and 257 healthy controls. Noncognitive NPS, specifically anxiety and depression, were more common in IIH patients compared to controls. Patients with IIH also reported increased headache, visual disturbances, and overall poorer quality of life. Limitations included heterogeneous sample characteristics along with variability in measurement of noncognitive NPS between studies.

Conclusions

A greater understanding of the most prevalent noncognitive NPS such as depression and anxiety in IIH patients, particularly among females who are obese and facing social and economic marginalization, may help to reduce IIH-associated morbidity. In particular, improved screening and timely management of psychiatric conditions using a multidisciplinary approach may improve IIH outcomes.