Mental Health Assessment and Suitability for Cognitive-Behavioral Therapy Among Patients With Idiopathic Intracranial...

High rates of mental health conditions have been reported among patients with idiopathic intracranial hypertension (IIH). Cognitive-behavioral therapy (CBT) has been suggested as a complementary treatment to help manage anxiety and headache pain in IIH. This study aims to assess the mental health of IIH patients through a psychiatric interview and to evaluate their suitability and interest in CBT.

Participants with IIH were recruited from Stanford Byers Eye Institute. Demographic and clinical characteristics were collected, and participants completed self-rated scales for depression (PHQ-9), anxiety (GAD-7), headaches (HIT-6), and disability (WHODAS-12). Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnoses, patient's suitability for CBT (SSCT scale), and preferred therapy focus were identified through a formal psychiatric interview.

Fifty-three participants were enrolled and completed surveys, and 43 participants went on to have the psychiatric interview (mean age 38 years, 91% female). Among them, 76.7% had a GAD-7 score ≥5, indicating at least mild anxiety, and 76.7% of participants had a PHQ-9 score ≥5, indicating at least mild depression. In total, 81.4% of participants suffered from a mood, anxiety, or trauma- and stressor-related disorder. Participants who had received a venous stent or VP shunt had higher anxiety levels (average GAD-7 11.75 vs 6.52; P = 0.007); 81.4% were interested in CBT, and 83.7% were deemed good candidates for CBT (SSCT ≥ 30). Anxiety management most often emerged as their favored therapeutic focus.

Our results confirm the high prevalence of mental health conditions and symptoms among patients with IIH. A majority of patients are interested in CBT, and many would likely benefit from this approach. CBT should therefore be considered in the therapeutic management of IIH. Further research is warranted to validate the efficacy of this intervention in this specific clinical population.