Neuropsychological Disorders in Patients with Brain Tumor

Background: Very few studies have utilized specific criteria to assess mental disorders in brain tumor patients. This study aimed to diagnose mental disorders in this population using DSM-IV (depression, sleep, and mood) criteria. Methods: From March 2007 to July 2009, the surgically treated patients with intracranial neoplasm were included in the study. These patients were examined in an ambulatory neuro-oncology clinic setting using a structured psychiatric interview which followed current DSM-IV diagnostic criteria. Results: This study is based on the clinical data of 89 patients with brain tumor. The mean age was 42.2 years old. Fifty five percent (55 %) of the patients were male. In our study, the prevalence of mild depression was about 30% for males and 38% for females. Before tumor operation, severe anxious as well as severe obsessive-compulsive symptoms were present in 14% of males. In females, 29% of the subjects had reported to have severe anxiousness and 25% severe obsessive symptoms. Conclusion: Depressive symptoms as well as anxious and obsessive psychopathology were shown to be prevalent signs among patients with brain tumor. The associated factors are tumor location, patient’s premorbid psychiatric status, cognitive symptoms and adaptive or maladaptive response to stress. Key Words: Brain Tumor; Psychological; Treatment References 1. Passik SD, Malkin MG, Breitbart WS, Horowitz S. Psychiatric and Psychosocial aspects of neurooncology. J Psychosoc Oncol 1994; 12: 101-22. 2. Salander P, Bergenheim T, Henriksson R . The creation of protection and hope in patients with malignant brain tumours. Soc Sci Med 1996; 42: 985-96. 3. Weitzner MA. Psychosocial and neuropsychiatric aspects of patients with primary brain tumors. Cancer Invest 1999; 17(4):285-91,Review. 4. Scheibel RS, Meyers CA, Levin VA. Cognitive dysfunction following surgery for intraceregral glioma: influence of histopathology, lesion location, and treatment. J Neurooncol 1996; 30: 61-9. 5. Irle E, Peper M, Wowra B, Kunze S. Mood changes after surgery for tumors of the cerebral cortex. Arch Neurol 1994; 51: 164-74. 6. Weitzner MA, Meyers CA. Cognitive functioning and quality of life in malignant glioma patients: a review of the literature. Psycho- Oncology 1997; 6: 169-77. 7. Aiken RD. Quality-of-life issues in patients with malignant gliomas. Semin Oncol 1994; 21: 273- 5. 8. Lovely MP. Quality of life of brain tumor patients. Semin Oncol Nurs 1988; 14: 73-80. 9. Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: reliability, validity and guidelines. J Clin Oncol 1984; 2: 180-93. 10. Haines A, Cooper J, Meade TW. Psychological characteristics and fatal ischaemic heart disease. Heart 2001; 85: 385-9. 11. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck depression Inventory: twenty-five years of evaluation. Clin Psychol Rev 1988; 8: 77-100. 12. Weitzner MA. Psychosocial and neuropsychiatric aspects of patients with primary brain tumors. Cancer Invest 1999; 17: 285-91. 13. Fox S. Use of Quality of life instrument to improve assessment of brain tumor patients in outpatient setting. J Neurosci Nurs 1998; 30: 322-5. 14. Horrobin DF, Bennet CN. Depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis. Prostaglandins Leukotri Essent Fatty Acids 1999; 60: 217-34. 15. Carson AJ, MacHale S, Allen K, Lawrie SM, Dennis M, House A, et al. Depression after stroke and lesion location: a systematic review. Lancet 2000; 356: 122-6. 16. Anderson SW, Damasio H , Tranel D. Neuropsychological impairments associated with lesions caused by tumor or stroke. Arch Neurol 1990; 47: 397-405. 17. Davis FG, Kupelian V, Freels S, McCarthy B, Surawicz T. Prevalence estimates for primary brain tumors in the United States by behavior and major histology groups. Neurooncol 2001; 3: 152-8. 18. Price TRP, Goetz KL, Lowell MR. Neuropsychaitric aspects of brain tumors, American Psychiatric Textbook of Neuropsychiatry, 2nd Edition. Edited by Yudofsky SC, Hales RE. Washington DC, American Psychiatric Press 1992; 473-97. 19. Spiegel D. Cancer and depression. Br J Psych 1996; 168: 109-116. 20. Spiegel D, Giese-Davis J. Depression and cancer: Mechanisms and disease progression. Biol Psychiatry 2003; 54: 269-82. 21. Evans DL, Charney DS. Mood disorders and medical illness: A major public health problem. Biol Psychiatry 2003; 54: 177-80. 22. Hollander E, Kwon JH, Stein DJ, Broatch J, Rowla CT , Himmelein CA. Obsessive compulsive and spectrum disorders: overview and quality of life issues. J Clin Psychiatry 1996; 57 (suppl 8): 3-6. 23. Pelletier G, Verhoef MJ, Khatri N , Hagen N. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neuro oncol 2002; 57: 41- 9.