Brain tumor and mood disorders: a retrospective analysis of anxiety and depression in patients with primary and metastatic brain tumors

Neurosurg Rev. 2024 Dec 28;48(1):10. doi: 10.1007/s10143-024-03169-3.

Abstract

Brain tumors are associated with a dismal prognosis, and the diagnosis often evokes significant psychological distress. However, the progression of emotional well-being throughout the clinical course of brain tumors remains poorly understood. This study aims to assess the prevalence of anxiety and depression in brain tumor patients and to identify the risk factors associated with postoperative emotional derangement in glioma and metastatic groups seperately. Psychological conditions were evaluated using the Hospital Anxiety and Depression Scale (HADS) at various preoperative and postoperative time points. A total of 159 patients who underwent surgery and HADS assessment between May 2018 and November 2020 were included in the analysis, comprising 112 glioma patients and 47 metastatic brain tumor patients. After surgery, the incidence of anxiety and depression increased in both the glioma and the metastatic brain tumor group. In both groups, tumors involving the frontal lobe were associated with a significant increase in postoperative HADS depression scores, whereas involvement of other lobes did not significantly affect postoperative HADS scores. Additionally, postoperative HADS scores did not differ significantly among gliomas of different grades. Among glioma patients, univariate analysis indicated that left-sided tumors were associated with an increased risk of postoperative depression worsening. In the metastatic group, a BMI > 24 was identified as a risk factor for postoperative anxiety exacerbation. The findings from this study highlight clinical characteristics associated with a higher risk of postoperative psychological disturbance, aiding in early prevention and tailored care to improve the quality of life for patients with intracranial tumors.

Keywords: Anxiety; Brain metastasis; Depression; Glioma; Hospital anxiety and depression scale.

MeSH terms

  • Adult
  • Aged
  • Anxiety* / epidemiology
  • Brain Neoplasms* / psychology
  • Brain Neoplasms* / secondary
  • Brain Neoplasms* / surgery
  • Depression* / epidemiology
  • Female
  • Glioma* / complications
  • Glioma* / psychology
  • Glioma* / surgery
  • Humans
  • Male
  • Middle Aged
  • Mood Disorders / epidemiology
  • Postoperative Complications / epidemiology
  • Postoperative Complications / psychology
  • Quality of Life
  • Retrospective Studies
  • Risk Factors