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Study of Association of Various Psychiatric Disorders in Brain TumorsFunding None.
Background Brain tumors may be associated with high morbidity, and psychiatric symptoms may be an early manifestation. It is important to address mental symptoms as early as possible because they are prone to develop psychiatric comorbidities in future. If untreated, these situations may worsen and lead to burden upon caregivers.
Methods A total of 176 brain tumor patients between January 2021 and January 2022 constituted the sample size. All recently diagnosed cases of brain tumor with age equal to or more than 18 years who can comprehend and answer questionnaires were included. Patients with a long history of brain tumor or who had a history of a psychiatric illness other than presenting symptoms or any other serious medical illness were excluded.
Results Twenty-seven percent of brain tumor patients had psychiatric symptoms. Depressive symptoms were the most common, associated with 24% of patients, followed by anxiety disorders. Psychiatric disorders were more common in supratentorial compared to infratentorial tumors. Psychiatric symptoms seem to be associated more commonly with malignant tumors and peritumoral edema. Among malignant tumors, depressive symptoms tend to be related with high-grade glioma, and among benign tumors, they were more common in meningioma. No predilection to laterality and anatomical lobe involvement is reported.
Conclusion Screening of psychiatric disorders should be a routine in brain tumor patients. An integrated approach is required to treat brain tumor patients. Healthcare professionals should be more vigilant about the onset of psychiatric symptoms and the need of palliative care to improve the quality of life.
All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Anand K. Das, Achal Sharma, Akhilesh Jain, Devendra K. Purohit, Ram K. Solanki, and Ajay Gupta. The first draft of the manuscript was written by Anand K. Das and all authors commented on previous versions of the manuscript. All authors read and approved the final version of manuscript.
The study was approved by the Institution's Ethics Committee (Protocol No. 309 MC/EC/2021).
The data associated with the paper are not publicly available but are available from the corresponding author on reasonable request.
Article published online:
28 October 2022
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- 1 Price TR, Goetz KL, Lovell MR. Neuropsychiatric aspects of brain tumors. In: Yudofsky SC, Hales RE. eds. Textbook of Neuropsychiatry and Behavioral Neurosciences. Turin: Am Psychiatr Publ; 2007: 735-764
- 2 American Brain Tumor Association. Neuropsychiatric Symptoms of Brain Tumors. 2019 (Accessed April 6, 2022). Accessed Aug 30, 2022, at: https://www.abta.org/wpcontent/uploads/2019/07/Neuropsychiatric-Symptoms-of-Brain-Tumors_7-19.pdf
- 3 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 Neurooncol 2002; 57 (01) 41-49
- 4 Kocher R, Linder M, Stula D. [Primary brain tumors in psychiatry]. Schweiz Arch Neurol Neurochir Psychiatr 1984; 135 (02) 217-227
- 5 Madhusoodanan S, Danan D, Brenner R, Bogunovic O. Brain tumor and psychiatric manifestations: a case report and brief review. Ann Clin Psychiatry 2004; 16 (02) 111-113
- 6 Uribe VM. Psychiatric symptoms and brain tumor. Am Fam Physician 1986; 34 (02) 95-98
- 7 Litofsky NS, Resnick AG. The relationships between depression and brain tumors. J Neurooncol 2009; 94 (02) 153-161
- 8 Madhusoodanan S, Ting MB, Farah T, Ugur U. Psychiatric aspects of brain tumors: a review. World J Psychiatry 2015; 5 (03) 273-285
- 9 Gibson AW, Graber JJ. Distinguishing and treating depression, anxiety, adjustment, and post-traumatic stress disorders in brain tumor patients. Ann Palliat Med 2021; 10 (01) 875-892
- 10 Ball C. The psychiatric presentation of a cerebellopontine angle tumour. Ir J Psychol Med 1996; 13: 21-23
- 11 Madhusoodanan S, Danan D, Moise D. Psychiatric manifestations of brain tumors: diagnostic implications. Expert Rev Neurother 2007; 7 (04) 343-349
- 12 Keschner M, Bender MB, Strauss I. Mental symptoms associated with brain tumor: a study of 530 verified cases. J Am Med Assoc 1938; 110: 714-718
- 13 Madhusoodanan S, Opler MG, Moise D. et al. Brain tumor location and psychiatric symptoms: is there any association? A meta-analysis of published case studies. Expert Rev Neurother 2010; 10 (10) 1529-1536
- 14 Zivković N, Marković M, Mihajlović G, Jovanović M. Surgical treatment of intradiploic epidermoid cyst treated as depression. Srp Arh Celok Lek 2014; 142 (1-2): 67-71
- 15 The World Medical Association. WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. 2013 (Accessed April 8, 2022). Accessed Aug 30, 2022, at: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
- 16 World Health Organization. Schedules for Clinical Assessment in Neuropsychiatry: Version 2. American Psychiatric Press; 1994
- 17 Aboraya A, Tien A, Stevenson J, Crosby K. Schedules for Clinical Assessment in Neuropsychiatry (SCAN): introduction to WV's mental health community. W V Med J 1998; 94 (06) 326-328
- 18 Lambertz N, Hindy NE, Adler C. et al. Expression of aquaporin 5 and the AQP5 polymorphism A(-1364)C in association with peritumoral brain edema in meningioma patients. J Neurooncol 2013; 112 (02) 297-305
- 19 Louis DN, Perry A, Reifenberger G. et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 2016; 131 (06) 803-820
- 20 Dautricourt S, Marzloff V, Dollfus S. Meningiomatosis revealed by a major depressive syndrome. BMJ Case Rep 2015; 2015: bcr2015211909
- 21 Fisher R, Harper C. Depressive illness as a presentation of primary lymphoma of the central nervous system. Aust N Z J Psychiatry 1983; 17 (01) 84-90
- 22 Spence SA, Taylor DG, Hirsch SR. Depressive disorder due to craniopharyngioma. J R Soc Med 1995; 88 (11) 637-638
- 23 Burkle Jr FM, Lipowski ZJ. Colloid cyst of the third ventricle presenting as psychiatric disorder. Am J Psychiatry 1978; 135 (03) 373-374
- 24 Fu X, Wu C, Han N. et al. Depressive and anxiety disorders worsen the prognosis of glioblastoma. Aging (Albany NY) 2020; 12 (20) 20095-20110
- 25 Leo RJ, Frodey JN, Ruggieri ML. Subtle neuropsychiatric symptoms of glioblastoma multiforme misdiagnosed as depression. BMJ Case Rep 2020; 13 (03) 233208
- 26 Mordecai D, Shaw RJ, Fisher PG, Mittelstadt PA, Guterman T, Donaldson SS. Case study: suprasellar germinoma presenting with psychotic and obsessive-compulsive symptoms. J Am Acad Child Adolesc Psychiatry 2000; 39 (01) 116-119
- 27 Bunevicius A, Deltuva VP, Deltuviene D, Tamasauskas A, Bunevicius R. Brain lesions manifesting as psychiatric disorders: eight cases. CNS Spectr 2008; 13 (11) 950-958
- 28 Srivastava S, Bhatia MS, Gaur A, Singh G. Psychiatric and cognitive correlates of quality of life among persons with primary brain tumors. Ind Psychiatry J 2019; 28 (01) 141-147
- 29 Mainio A, Hakko H, Niemelä A, Koivukangas J, Räsänen P. Somatization symptoms are related to right-hemispheric primary brain tumor: a population-based prospective study of tumor patients in northern Finland. Psychosomatics 2009; 50 (04) 331-335
- 30 Bommakanti K, Gaddamanugu P, Alladi S. et al. Pre-operative and post-operative psychiatric manifestations in patients with supratentorial meningiomas. Clin Neurol Neurosurg 2016; 147: 24-29
- 31 Vranic A, Gilbert F. Prognostic implication of preoperative behavior changes in patients with primary high-grade meningiomas. ScientificWorldJournal 2014; 2014: 398295
- 32 Oosthuizen P. The neuropsychiatry of brain tumours. S Afr J Psychiatr 2005; 11: 6-9
- 33 Kaloshi G, Alikaj V, Rroji A, Vreto G, Petrela M. Visual and auditory hallucinations revealing cerebellar extraventricular neurocytoma: uncommon presentation for uncommon tumor in uncommon location. Gen Hosp Psychiatry 2013; 35 (06) 680.e1-680.e3
- 34 Cummings JL, Benson DF. Dementia: A Clinical Approach. Boston, MA: Butterworth-Heinemann Medical; 1992
- 35 Filley CM, Kleinschmidt-DeMasters BK. Neurobehavioral presentations of brain neoplasms. West J Med 1995; 163 (01) 19-25
- 36 Mainio A, Hakko H, Niemelä A, Koivukangas J, Räsänen P. Depression in relation to anxiety, obsessionality and phobia among neurosurgical patients with a primary brain tumor: a 1-year follow-up study. Clin Neurol Neurosurg 2011; 113 (08) 649-653
- 37 Rooney AG, Carson A, Grant R. Depression in cerebral glioma patients: a systematic review of observational studies. J Natl Cancer Inst 2011; 103 (01) 61-76
- 38 Rooney AG, McNamara S, Mackinnon M. et al. Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma. J Clin Oncol 2011; 29 (32) 4307-4312
- 39 Houy E, Debono B, Dechelotte P, Thibaut F. Anorexia nervosa associated with right frontal brain lesion. Int J Eat Disord 2007; 40 (08) 758-761
- 40 Arasappa R, Danivas V, Venkatasubramanian G. Choroid plexus papilloma presenting as schizophrenia: a case report. J Neuropsychiatry Clin Neurosci 2013; 25 (01) E26-E27