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Mood Disorders in Patients with CNS Metastases

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Central Nervous System Metastases

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Abstract

Mood disorders and cancer are linked through shared pathology that involves inflammation, oxidative stress, decreased immune surveillance, and dysfunction of the HPA axis. Cancer treatment often involves interventions that can, directly or indirectly, contribute to mood symptoms. Patients with cancer are at up to three times greater risk for depression compared to the general population, and advanced disease and central nervous system (CNS) involvement are additional risk factors. The presence of a mood disturbance impacts patient decision-making related to cancer treatment and is associated with poorer cancer-related outcomes, including medication nonadherence, comorbid substance misuse and relapse, higher healthcare utilization and costs, and mortality. Depressive and bipolar disorders are reviewed, particularly as they relate to patients with metastatic involvement of the CNS. Strategies for the screening and treatment of mood disorders in the medical setting are discussed.

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Abbreviations

AEDs:

Antiepileptic drugs

CBT:

Cognitive behavioral therapy

CNS:

Central nervous system

DBT:

Dialectical behavior therapy

DSM-V:

Diagnostic and Statistical Manual of Mental Disorders, fifth edition

HADS:

Hospital Anxiety and Depression Scale

HPA axis:

Hypothalamic-pituitary-adrenal axis

IL-2:

Interleukin-2

IL-6:

Interleukin-6

MBSR:

Mindfulness-based stress reduction

MDD:

Major depressive disorder

NCCN:

National Comprehensive Cancer Network

NSAIDs:

Nonsteroidal anti-inflammatory drugs

PHQ-9:

Patient Health Questionnaire-9

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Authors and Affiliations

  1. Psychosocial Oncology, Department of Behavioral Medicine and Psychiatry, West Virginia University Cancer Institute, Morgantown, WV, USA

    Kaleena Chilcote

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  1. Kaleena Chilcote
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Correspondence to Kaleena Chilcote .

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Editors and Affiliations

  1. Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, Director - Brain Metastases Program, New York, NY, USA

    Rohan Ramakrishna

  2. Department of Neurology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA

    Rajiv S. Magge

  3. Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA

    Ali A. Baaj

  4. Department of Radiation Oncology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA

    Jonathan P.S. Knisely

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Chilcote, K. (2020). Mood Disorders in Patients with CNS Metastases. In: Ramakrishna, R., Magge, R., Baaj, A., Knisely, J. (eds) Central Nervous System Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-42958-4_11

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  • DOI: https://doi.org/10.1007/978-3-030-42958-4_11

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