Abstract
Objective: We aimed to assess psychological distress in patients with intracranial neoplasia, a group of patients who suffer from severe functional, neurocognitive and neuropsychological side effects, resulting in high emotional distress.Methods: We conducted a cross-sectional study, including inpatients with brain tumours. Eligible patients completed validated self-report questionnaires measuring depression, anxiety, distress, symptoms of posttraumatic stress disorder (PTSD), fear of progression and health-related quality of life. The questionnaire set was completed after brain surgery and receiving diagnosis and before discharge from hospital.Results: A total of n = 31 patients participated in this survey. Fourteen of them suffered from malignant (n = 3 metastatic neoplasia) and 17 from benign brain tumours. Mean values of the total sample regarding depression (M = 9.28, SD = 6.08) and anxiety (M = 6.00, SD = 4.98) remained below the cut-off ≥ 10. Mean psychosocial distress (M = 16.30, SD = 11.23, cut-off ≥ 14) and posttraumatic stress (M = 35.10, SD = 13.29, cut-off ≥ 32) exceeded the clinically relevant cut-off value in all the patients with intracranial tumours. Significantly, more patients with malignant (79%) than benign (29%) brain tumours reported PTSD symptoms (p = 0.006).Conclusion: Distress and clinically relevant PTSD symptoms in patients with intracranial neoplasia should be routinely screened and treated in psycho-oncological interventions immediately after diagnosis. Especially, neuro-oncological patients with malignant brain tumours or metastases need targeted support to reduce their emotional burden.
Highlights
The average annual age-adjusted incidence of primary brain and nervous system tumours among adults ( ≥ 40 years) is estimated to be 44.47 per 100,000 of the population
We aimed to assess distress in neuro-oncological patients, and in summary, we note that group differences were not statistical significant in most comparisons, the descriptive results pattern reveals that psychosocial distress was higher in the malignant brain tumour group with regard to symptoms of depression and anxiety, as post-traumatic stress and somatic symptoms
We found that the malignant tumour group scored on average above the cut-off value in the PHQ-9 depression module, which strongly suggests major depression symptoms among these patients in contrast to the benign tumour group
Summary
The average annual age-adjusted incidence of primary brain and nervous system tumours among adults ( ≥ 40 years) is estimated to be 44.47 per 100,000 of the population. One-third of these are malignant CNS tumours, which is the eighth most common cancer among men and the fifth among women in this age group. Psychological Distress in Intracranial Neoplasia entity, whereas glioblastoma is the most common malignant intracranial tumour, except for metastases (Ostrom et al, 2018). It is noteworthy that 20–40% of all patients diagnosed with an invasive solid malignancy originating outside the CNS develop brain metastases during the progression of their disease (Cagney et al, 2017). Neuro-oncologic therapy strategies range from observation for benign tumours to complex multimodal treatments for malignant entities. Disease progression often results in serious side effects, such as paralysis, epileptic seizures, aphasia or changes in personality
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