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BACKGROUND Arachnoid cysts yield cognitive deficits that are normalized after surgical cyst decompression. OBJECTIVE The present study aimed at investigating whether arachnoid cysts also affect symptoms of anxiety and depression, and if surgical cyst decompression leads to reduction of these symptoms. METHODS 22 adult patients (13 males, 9 females) with symptomatic temporal or frontal cysts were included in this questionnaire (HADS) based prospective study. The mean time between answering the preoperative questionnaire and surgery was 37 days. The patients answered the same HADS questionnaire 3 - 6 months postoperatively. RESULTS Preoperatively, both frontal (N=4) and temporal (N=18) cyst patients had higher mean HADS anxiety scores than what is found in the general population. For temporal cyst patients, there was a significant or near-significant difference in anxiety and depression scores and the combined scores between those with right sided cysts and those with left sided cysts. Postoperatively, the HADS scores normalized and were no longer different from the general population. The difference in scores between right and left temporal cyst patients also disappeared. CONCLUSION Arachnoid cyst patients have higher levels of anxiety and depression than the general population and these scores were normalized subsequent to decompressive cyst surgery. We further found a hemispheric asymmetry: patients with a right temporal cyst displayed higher anxiety, depression, and combined scores than subjects with a left temporal cyst. Also this disparity normalized following cyst decompression. Thus, arachnoid cysts appear to affect not only cognition, but also the level of affective symptoms.