title: The pre-interventional psychiatric history - an underestimated confounder in benign intracranial lesions studies.
abstract: OBJECTIVE
  The current study was designed to analyze the influence of a positive pre-interventional psychiatric history on the quality of life (QOL) after successful treatment of benign intracranial extra-cerebral lesions.
  
  
  METHODS
  Patients treated due to meningioma WHO I or unruptured intracranial aneurysms in two German neurosurgical centers between 2007 and 2013 were screened for exclusion criteria including malignant/chronic diseases, recurrence of the tumor/aneurysm and neurological deficits among others. 131 patients who met the criteria of an objectively unaffected health status were included. The pre-interventional psychiatric histories and the rates of post-interventional headaches, sleeping disorders, symptoms of chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD) and QOL were determined by questionnaires which were mailed to the patients.
  
  
  RESULTS
  103 patients returned the questionnaires. Despite the objectively unaffected health status, the patients with a positive pre-interventional psychiatric history demonstrated a post-interventionally significantly lower QOL (p=0.002), a significantly higher Pittsburgh Sleep Quality Index sum score (p=0.009), as well as significantly higher rates of symptoms of a chronic fatigue syndrome (p=0.003) and PTSD (p=0.024), compared to the patient collective with a negative pre-interventional psychiatric status.
  
  
  CONCLUSIONS
  The results of the current study demonstrate the importance of taking the pre-interventional psychiatric history as a significant and independent confounder into consideration when evaluating the outcome after treatment of benign intracranial extra-cerebral lesions. A pre-interventional psychiatric screening and an early psychological intervention might help to improve the overall outcome after successful treatment of such lesions.
authors.affiliation: Department of Neuroradiology, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68161 Mannheim, Germany. Electronic address: holger.wenz@umm.de.
authors.forename: H
authors.initials: H
authors.lastname: Wenz
authors.affiliation: Department of Neuroradiology, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68161 Mannheim, Germany. Electronic address: wenz.ralf@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Wenz
authors.affiliation: Department of Neuroradiology, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68161 Mannheim, Germany. Electronic address: christoph.groden@umm.de.
authors.forename: C
authors.initials: C
authors.lastname: Groden
authors.affiliation: Department of Neurosurgery, Ruhr-University Bochum, In der Schornau 23-25, 44892 Bochum, Germany. Electronic address: Kirsten.schmieder@kk-bochum.de.
authors.forename: K
authors.initials: K
authors.lastname: Schmieder
authors.affiliation: Department of Neurosurgery, Ruhr-University Bochum, In der Schornau 23-25, 44892 Bochum, Germany. Electronic address: johann.fontana@kk-bochum.de.
authors.forename: J
authors.initials: J
authors.lastname: Fontana
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006261:Headache / Q000523:psychology*; D006801:Humans; D002532:Intracranial Aneurysm / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology* / Q000601:surgery; D011788:Quality of Life / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000601:surgery; D011795:Surveys and Questionnaires
keywords: Meningioma; Post-traumatic stress disorder; Psychiatric history; Quality of life; Sleep disorders; Unruptured aneurysm