Incidence rates for depression and anxiety has not been previously evaluated in a large matched cohort study in idiopathic intracranial hypertension (IIH).

We analysed data collected between January-1995 and September-2019 from IQVIA Medical Research Data, an anonymised and nationally representative UK database. Crude incident rates for depression and anxiety were calculated in IIH, migraine controls and population controls matched by age and body mass index (BMI). Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI).

Anxiety incidence was 12.4, 12.6 and 8.2 per 1000 person-years in IIH, migraine and controls, respectively. For IIH, the adjusted HR for anxiety was 1.40 (CI=1.19-1.64) compared to controls, and 0.98 (CI=0.83-1.14) compared to migraine. Depression incidence was 20.1, 19.5 and 13.3 per 1000 person-years in IIH, migraine and controls, respectively. Compared to controls, depression adjusted HR in IIH was 1.38 (CI 1.20-1.58); compared to migraine, adjusted HR was 0.98 (CI 0.86-1.13).

Anxiety and depression are not more common in IIH compared to matched migraine population, but the hazard of anxiety and depression was approximately 40% higher compared to healthy age and BMI-matched controls. Physician recognition and management of this co-morbidity is an unmet clinical need in IIH.