Skip to main content

Advertisement

Log in

Suicidal ideation in patients undergoing brain tumor surgery: prevalence and risk factors

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Suicidal ideation (SI) is an important complication in cancer patients that should be promptly recognized and adequately managed. We investigated the prevalence rate and correlates of pre-operative SI in brain tumor (BT) patients admitted for elective BT surgery.

Methods

Two hundred and eleven consecutive patients (70 % women; mean age 55.9 ± 15.4 years) scheduled for BT surgery were evaluated for SI (“suicidal thought” item from the Beck Depression Inventory-II), depressive/anxiety symptom severity (Hospital Anxiety and Depression scale (HADS)), health-related quality of life (SF-36 scale), functional status (Barthel Index), and psychiatric histories and treatments. The majority of patients were diagnosed with meningioma (39 %) and high-grade glioma (17 %).

Results

SI was self-reported by 12 (6 %) patients. Patients expressing SI were most commonly diagnosed with meningioma (50 %). Patients with SI were more likely to have a past history of psychiatric disorders, scored higher on the HADS anxiety subscale, and reported worse health-related quality of life across physical and mental health domains. In multivariate regression analyses, worse perceived mental health was associated with increased risk for SI independently from clinical, sociodemographic, and other patient-oriented variables considered in the study.

Conclusions

SI was self-reported by 6 % of BT patients before surgical intervention and was associated with a past history of psychiatric disorders and worse perceived health status. Poor mental health was an independent correlate of SI. The perception of health status by a patient should be considered as an important determinant of poor mental health in BT patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Vyssoki B, Gleiss A, Rockett IRH, et al. (2015) Suicide among 915,303 Austrian cancer patients: who is at risk? J Affect Disord 175:287–291. doi:10.1016/j.jad.2015.01.028

    Article  PubMed  Google Scholar 

  2. De la Grandmaison GL, Watier L, Cavard S, Charlier P (2014) Are suicide rates higher in the cancer population? An investigation using forensic autopsy data. Med Hypotheses 82(1):16–19. doi:10.1016/j.mehy.2013.10.025

    Article  PubMed  Google Scholar 

  3. Smailyte G, Jasilionis D, Kaceniene A, Krilaviciute A, Ambrozaitiene D, Stankuniene V (2013) Suicides among cancer patients in Lithuania: a population-based census-linked study. Cancer Epidemiol 7(5):714–718. doi:10.1016/j.canep.2013.05.009

    Article  Google Scholar 

  4. Spoletini I, Gianni W, Caltagirone C, Madaio R, Repetto L, Spalletta G (2011) Suicide and cancer: where do we go from here? Crit Rev Oncol Hematol 78(3):206–219. doi:10.1016/j.critrevonc.2010.05.005

    Article  PubMed  Google Scholar 

  5. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association DSM-5 Task Force. Washington D.C.

  6. Kim J, Jang J, Stewart R, et al. (2013) Determinants of suicidal ideation in patients with breast cancer. Psychooncolygy 22(12):2848–2856. doi:10.1002/pon.3367

    Article  Google Scholar 

  7. Walker J, Waters R A, Murray G, et al. (2008) Better off dead: suicidal thoughts in cancer patients. J Clin Oncol 26(29):4725–4730. doi:10.1200/JCO.2007.11.8844

    Article  PubMed  Google Scholar 

  8. Brinkman TM, Liptak CC, Delaney BL, Chordas CA, Muriel AC, Manley PE (2013) Suicide ideation in pediatric and adult survivors of childhood brain tumors. J Neuro-Oncol 113:425–432. doi:10.1007/s11060-013-1130-6

    Article  Google Scholar 

  9. Casey P, Dunn G, Kelly BD, et al. (2008) The prevalence of suicidal ideation in the general population: results from the Outcome of Depression International Network (ODIN) study. Soc Psychiatry Psychiatr Epidemiol 43(4):299–304. doi:10.1007/s00127-008-0313-5

    Article  PubMed  Google Scholar 

  10. Brinkman T, Zhang N, Recklitis C, et al. (2014) Suicide ideation and associated mortality in adult survivors of childhood cancer. Cancer 120(2):271–277. doi:10.1002/cncr.28385.Suicide

    Article  PubMed  PubMed Central  Google Scholar 

  11. Marks S, Heinrich TW, Rosielle D (2012) Case report: are clinicians obligated to medically treat a suicide attempt in a patient with a prognosis of weeks? J Palliat Med 15(1):134–137. doi:10.1089/jpm.2010.0530

    Article  PubMed  Google Scholar 

  12. Molassiotis A, Wilson B, Brunton L, Chaudhary H, Gattamaneni R, McBain C (2010) Symptom experience in patients with primary brain tumours: a longitudinal exploratory study. Eur J Oncol Nurs 14(5):410–416. doi:10.1016/j.ejon.2010.03.001

    Article  PubMed  Google Scholar 

  13. Pranckeviciene A, Bunevicius A (2015) Depression screening in patients with brain tumors: a review. CNS Oncol 4(2):71–78. doi:10.2217/cns.14.60

    Article  CAS  PubMed  Google Scholar 

  14. Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Laws ER Jr, Bunevicius R (2013) Low triiodothyronine syndrome as a predictor of poor outcomes in patients undergoing brain tumor surgery: a pilot study. J Neurosurg 118(6):1279–1287. doi:10.3171/2013.1.JNS121696

    Article  CAS  PubMed  Google Scholar 

  15. Wellisch DK, Kaleita TA, Freeman D, Cloughesy T, Goldman J (2002) Predicting major depression in brain tumor patients. Psychooncology 238:230–238

    Article  Google Scholar 

  16. Beck A, Steer R, Brown G (1996) Manual for the Beck Depression Inventory–II. Psychological Corporation, San Antonio, TX

    Google Scholar 

  17. Bunevicius A, Staniute M, Brozaitiene J, Bunevicius R (2012) Diagnostic accuracy of self-rating scales for screening of depression in coronary artery disease patients. J Psychosom Res 72(1):22–25. doi:10.1016/j.jpsychores.2011.10.006

    Article  PubMed  Google Scholar 

  18. Bunevicius A, Staniute M, Brozaitiene J, et al. (2012) Evaluation of depressive symptoms in patients with coronary artery disease using the Montgomery Åsberg Depression Rating Scale. Int Clin Psychopharmacol 27(5):249–255. doi:10.1097/YIC.0b013e328357670d

    Article  PubMed  Google Scholar 

  19. Ware JJ, Sherbourne C (1992) The MOS 36-item short-form health survey (SF-36). I Conceptual Framework and Item Selection Med Care 30(6):473–483. doi:10.1097/00005650-199206000-00002

    PubMed  Google Scholar 

  20. Bunevičius A, Tamašauskas Š, Tamašauskas A, Deltuva V (2012) Evaluation of health-related quality of life in Lithuanian brain tumor patients using the EORTC brain cancer module. Medicina (Kaunas) 48(11):588–594

    Google Scholar 

  21. Bunevicius A, Tamasauskas S, Deltuva V, Tamasauskas A, Radziunas A, Bunevicius R (2014) Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective. Acta Neurochir 56(2):367–374. doi:10.1007/s00701-013-1930-7

    Article  Google Scholar 

  22. Zigmond A, Snaith R (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  23. Bunevicius A, Deltuva V, Tamasauskas S, Tamasauskas A, Bunevicius R (2013) Screening for psychological distress in neurosurgical brain tumor patients using the Patient Health Questionnaire-2. Psychooncology 22(8):1895–1900. doi:10.1002/pon.3237

    Article  PubMed  Google Scholar 

  24. Rooney AG, Mcnamara S, Mackinnon M, et al. (2013) Screening for major depressive disorder validation of 3 self-report instruments. Neuro-Oncology 15(1):122–129. doi:10.1093/neuonc/nos282

    Article  PubMed  PubMed Central  Google Scholar 

  25. Goebel S, Mehdorn HM (2011) Measurement of psychological distress in patients with intracranial tumours: the NCCN distress thermometer. J Neuro-Oncol 104(1):357–364. doi:10.1007/s11060-010-0501-5

    Article  Google Scholar 

  26. Bunevicius R, Liaugaudaite V, Peceliuniene J, Raskauskiene N, Bunevicius A, Mickuviene N (2014) Factors affecting the presence of depression, anxiety disorders, and suicidal ideation in patients attending primary health care service in Lithuania. Scand J Prim Health Care 32(1):24–29. doi:10.3109/02813432.2013.873604

    Article  PubMed  PubMed Central  Google Scholar 

  27. Mahoney F, Barthel D (1965) Functional evaluation: the Barthel Index. Md State Med J 14:56–61

    Google Scholar 

  28. Lehuluante A, Fransson P (2014) Are there specific health-related factors that can accentuate the risk of suicide among men with prostate cancer? Support Care Cancer 22(6):1673–1678. doi:10.1007/s00520-014-2150-2

    Article  PubMed  PubMed Central  Google Scholar 

  29. Leung YW, Li M, Davins G, et al. (2013) Routine screening for suicidal intention in patient with cancer. Psycho-Oncology 22:2537–2545. doi:10.1002/pon.3319

    Article  PubMed  Google Scholar 

  30. Recklitis CJ, Diller LR, Li X, Najita J, Robison LL, Zeltzer L (2010) Suicide ideation in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 28(4):655–661. doi:10.1200/JCO.2009.22.8635

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kim J, Yoon J, Jang J, et al. (2013) Determinants of suicidal ideation in patients with breast cancer. Psychooncology 22:2848–2856. doi:10.1002/pon.3367

    Article  PubMed  Google Scholar 

  32. Turner CD, Chordas C A, CC L, et al. (2009) Medical, psychological, cognitive and educational late-effects in pediatric low-grade glioma survivors treated with surgery only. Pediatr Blood Cancer 53(3):417–423. doi:10.1002/pbc.22081

    Article  PubMed  Google Scholar 

  33. Zhou ES, Hu JC, Kantoff PW, Recklitis CJ (2015) Identifying suicidal symptoms in prostate cancer survivors using brief self-report. J Cancer Surviv 9(1):59–67. doi:10.1007/s11764-014-0385-z

    Article  PubMed  Google Scholar 

  34. Madeira N, Albuquerque E, Santos T, Mendes A, Roque M (2011) Death ideation in cancer patients: contributing factors. J Psychosoc Oncol 29(6):636–642. doi:10.1080/07347332.2011.615381

    Article  PubMed  Google Scholar 

  35. Breitbart W (1995) Identifying patients at risk for, and treatment of major psychiatric complications of cancer. Support Care Cancer 3(1):45–60

    Article  CAS  PubMed  Google Scholar 

  36. Recklitis CJ, Zhou ES, Zwemer EK, Hu JC, Kantoff PW (2014) Suicidal ideation in prostate cancer survivors: understanding the role of physical and psychological health outcomes. Cancer 120(21):3393–3400. doi:10.1002/cncr.28880

    Article  PubMed  Google Scholar 

  37. Tsay S-L, Chang J-Y, Yates P, Lin K-C, Liang S-Y (2012) Factors influencing quality of life in patients with benign primary brain tumors: prior to and following surgery. Support Care Cancer 20(1):57–64. doi:10.1007/s00520-010-1053-0

    Article  PubMed  Google Scholar 

  38. Brown PD, Ballman KV, Rummans T A, et al. (2006) Prospective study of quality of life in adults with newly diagnosed high-grade gliomas. J Neuro-Oncol 76(3):283–291. doi:10.1007/s11060-005-7020-9

    Article  Google Scholar 

  39. Mainio A, Tuunanen S, Hakko H, Niemelä A, Koivukangas J, Räsänen P (2006) Decreased quality of life and depression as predictors for shorter survival among patients with low-grade gliomas: a follow-up from 1990 to 2003. Eur Arch Psychiatry Clin Neurosci 256(8):516–521. doi:10.1007/s00406-006-0674-2

    Article  PubMed  Google Scholar 

  40. Klein E, Altshuler D, Hallock A, Szerlip N (2014) Quality of life research in neuro-oncology: a quantitative comparison. J Neuro-Oncol 116(2):333–340. doi:10.1007/s11060-013-1299-8

    Article  Google Scholar 

  41. Litofsky NS, Resnick AG (2009) The relationships between depression and brain tumors. J Neuro-Oncol 94(2):153–161. doi:10.1007/s11060-009-9825-4

    Article  Google Scholar 

  42. Tang GX, Yan PP, Yan CL, et al. (2015) Determinants of suicidal ideation in gynecological cancer patients. Psychooncology. doi:10.1002/pon.3880.

    Google Scholar 

  43. Choi Y-N, Kim Y-A, Yun YH, et al. (2014) Suicide ideation in stomach cancer survivors and possible risk factors. Support Care Cancer 22(2):331–337. doi:10.1007/s00520-013-1975-4

    Article  PubMed  Google Scholar 

  44. Goebel S, Mehdorn HM (2013) Development of anxiety and depression in patients with benign intracranial meningiomas: a prospective long-term study. Support Care Cancer 21(5):1365–1372. doi:10.1007/s00520-012-1675-5

    Article  PubMed  Google Scholar 

  45. Goebel S, von Harscher M, Mehdorn HM (2011) Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase. Support Care Cancer 19(11):1797–1805. doi:10.1007/s00520-010-1021-8

    Article  PubMed  Google Scholar 

  46. Kilbride L, Smith G, Grant R (2007) The frequency and cause of anxiety and depression amongst patients with malignant brain tumours between surgery and radiotherapy. J Neuro-Oncol 84(3):297–304. doi:10.1007/s11060-007-9374-7

    Article  Google Scholar 

  47. Bunevicius A, Deltuva VP, Deltuviene D, Tamasauskas A, Bunevicius R (2008) Brain lesions manifesting as psychiatric disorders: eight cases. CNS Spectr 13(11):950–958

    PubMed  Google Scholar 

  48. Gupta RK, Kumar R (2004) Benign brain tumours and psychiatric morbidity: a 5-years retrospective data analysis. Aust N Z J Psychiatry 38(5):316–319. doi:10.1111/j.1440-1614.2004.01357.x

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Juste Buneviciute for her assistance with the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aiste Pranckeviciene.

Ethics declarations

The study protocol and consent procedure were approved by the Ethics Committee for Biomedical Research of the Lithuanian University of Health Sciences. Written informed consent was obtained from each study patient.

Funding

This study was funded by Research Council of Lithuania (project No. MIP-044/2015).

Conflict of interest

The authors declare that they have no conflict of interest. Authors state that they have full control of all primary data and agree to allow the journal to review it if requested.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pranckeviciene, A., Tamasauskas, S., Deltuva, V.P. et al. Suicidal ideation in patients undergoing brain tumor surgery: prevalence and risk factors. Support Care Cancer 24, 2963–2970 (2016). https://doi.org/10.1007/s00520-016-3117-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3117-2

Keywords

Navigation