Rates of Comorbid Psychiatric Conditions Among Adults With Hydrocephalus at a Hydrocephalus Specialty Center

The relationship between hydrocephalus and comorbid psychiatric conditions among adults remains unclear. The authors characterized the prevalence of psychiatric conditions among adult patients with hydrocephalus and compared the rates of these conditions among hydrocephalus subtypes.

A retrospective study of patients ages ≥18 years from a tertiary hydrocephalus specialty center was conducted by reviewing electronic health record data. Participants (N=2,668) were required to have an ICD-10 diagnosis of hydrocephalus (G91) or congenital hydrocephalus (Q03) in their active problem list. Hierarchical logistic regression analysis was performed to compare psychiatric outcomes among hydrocephalus subtypes after analyses had been adjusted for age at the last visit, gender, and number of hydrocephalus center encounters.

Overall, 31% of the study participants had at least one comorbid psychiatric condition, most commonly depression (15%), anxiety disorder (10%), dementia (7%), or a substance use disorder (5%). Female gender was significantly associated with depression and anxiety disorder. Older age was linked to increased odds of dementia and a history of psychiatric encounters, and younger age was associated with anxiety disorders, substance use disorders, intellectual disability, developmental disorders, and childhood-onset behavioral and emotional disorders. Congenital hydrocephalus was associated with higher odds of intellectual disability, and no significant difference in psychiatric outcomes was detected between communicating and obstructive hydrocephalus.

Comorbid psychiatric conditions affect a substantial proportion of adult patients with hydrocephalus. Age and gender differences in psychiatric diagnoses resemble trends in the general population. These findings highlight a need to improve psychiatric screening among adult patients with hydrocephalus.