Abstract
BackgroundMental symptoms are common and associated with worse health status of brain tumor patients. We evaluated the association of pre-operative depressive and anxiety symptoms with 5-year mortality of glioma and meningioma patients.MethodsOne-hundred and fifty-two patients (mean age 56.9±14.7 years, 69% women) were evaluated for functional status (Barthel index), and depressive and anxiety symptom severity (Hospital Anxiety and Depression scale or HADS). Patients were categorized as having mild, moderate or severe depressive/anxiety symptoms if they scored ≤7, 8-10 or ≥11 on the HADS, respectively. Information pertaining to histological diagnosis, extent of resection and adjuvant therapies were obtained from medical records. Follow-up continued through November, 2015.ResultsForty-three patients were diagnosed with high-grade glioma, 20 with low-grade glioma and 89 with meningioma. Moderate to severe depressive and anxiety symptoms were diagnosed in 28% and 36% of patients, respectively. In meningioma patients, survival was the shortest in patients with severe depressive symptoms (40.32±7.92 months) followed by patients with moderate (46.66±6.05 months) and mild (55.68±1.77 months) depressive symptoms (Log-Rank = 6.211, p = 0.045). After adjusting for patients’ age, gender, functional status, extent of resection, history of depression, and tumor location, laterality and grade, severe depressive symptoms were associated with increased 5-year mortality risk of meningioma patients (HR = 7.083 [95%CI: 1.755–28.588], p = 0.006). Depressive and anxiety symptoms were not associated with mortality of glioma patientsConclusionsDepressive and anxiety symptoms are common in glioma and meningioma patients. Pre-operative depressive symptoms are associated with shorter survival of meningioma patients independently from clinical prognostic indicators.
Highlights
Primary brain tumors are rare diseases with annual age-adjusted incidence rate of 28.57 per 100,000 population [1]
After adjusting for patients’ age, gender, functional status, extent of resection, history of depression, and tumor location, laterality and grade, severe depressive symptoms were associated with increased 5-year mortality risk of meningioma patients (HR = 7.083 [95%CI: 1.755–28.588], p = 0.006)
Depressive and anxiety symptoms are common in glioma and meningioma patients
Summary
Primary brain tumors are rare diseases with annual age-adjusted incidence rate of 28.57 per 100,000 population [1]. Psychiatric disorders and symptoms are common complications of brain tumors [5, 6]. Depression is the most common psychiatric symptom of meningioma patients [7] affecting more than 20% of patients [8]. The association of depression with survival of brain tumor patients remains unclear. In high grade glioma patients, two previous studies found that depressive disorder predicted shorter survival [11, 12], while another prospective study did not find an association between depressive symptoms patients prognosis [13]. Depressive symptoms were associated with a shorter survival of patients with low-grade gliomas, but not benign brain tumors [13]. Mental symptoms are common and associated with worse health status of brain tumor patients. We evaluated the association of pre-operative depressive and anxiety symptoms with 5-year mortality of glioma and meningioma patients
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