Abstract
Purpose
The aim of this study was to provide the first prospective longitudinal assessment of anxiety and depression in patients with a benign intracranial meningioma (WHO° I).
Methods
The Hospital Anxiety and Depression Scale was applied prior to (t1) and directly after (t2) neurosurgery as well as 6 months after surgery (t3). The research was conducted in a single treatment centre in Germany. Numerous sociodemographic, medical, psychological and cognitive accompanying measures were assessed. The study population consisted of 52 meningioma patients. Additionally, a control group of 24 patients with malignant brain tumours (astrocytoma WHO° III) was assessed.
Results
In meningioma patients, anxiety was high prior to surgery but declined significantly after successful neurosurgical treatment. Low levels of depression were observed at all times. In contrast, astrocytoma patients showed constantly high levels of anxiety whilst depression increased over the course of the disease. Numerous medical, psychosocial and psychological factors were associated with psychiatric morbidity in meningioma patients.
Conclusions
In conclusion, psychiatric morbidity of patients with benign intracranial meningiomas was comparable to that of the general population after successful neurosurgical treatment. Numerous associated factors suggest complex relationships within a biopsychosocial model. However, due to the small sample size and recruitment in a single institution, our results are of limited generalisability and need cross-validation in future studies.
Similar content being viewed by others
Abbreviations
- WHO:
-
World Health Organization
- HADS:
-
Hospital Anxiety and Depression Scale
- KPS:
-
Karnofsky Performance Status. The KPS allows patients to be classified as to their functional impairment ranging from 100 (“normal, no complaints, no signs of disease” to 0 (“death”)
- HRQoL:
-
Health-Related Quality of Life
- EORTC QLQ C-30:
-
European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire
- PDS:
-
Posttraumatic Stress Diagnostic Scale
- FSozU:
-
Fragebogen zur Sozialen Unterstützung; one of the most frequently used measures of social support in Germany
- TMT:
-
Trail making test
References
Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114:97–109
Kleihues P, Burger PC, Scheithauer BW (1993) Histological typing of tumours of the central nervous system: international histological classification of tumours, 2nd edn. Springer, Berlin
Lee JH (2009) Meningiomas: diagnosis, treatment, and outcome, 1st edn. Springer, London
Pace A, Di Lorenzo C, Lorenzo CD, Guariglia L, Jandolo B, Carapella CM, Pompili A (2009) End of life issues in brain tumor patients. J Neuro-Oncol 91(1):39–43
Pringle A-A, Taylor R, Whittle IR (1999) Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. Br J Neurosurg 13:46–51
Chochinov HM (2001) Depression in cancer patients. Lancet Oncol 2:499–505
Zabora JR, BrintzenhofeSzoc KM, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-Oncol 10:19–28
Goebel S, Stark A, Kaup L, von Harscher M, Mehdorn HM (2011) Distress in patients with newly diagnosed brain tumours. Psycho Oncol 20(6):623–630
Giovagnoli AR, Boiardi A (1994) Cognitive impairment and quality of life in long-term survivors of malignant brain tumors. Ital J Neurol Sci 15(9):481–488
Tsay SL, Chang JY, Yates P, Lin KC, Liang SY (2012) Factors influencing quality of life in patients with benign primary brain tumors: prior to and following surgery. Support Care Cancer 20:57–64
Arnold SD, Forman LM, Brigidi BD, Carter KE, Schweitzer HA, Qiunn HE, Bebe Guill A, Herndon JE, Raynor RH (2008) Evaluation and characterization of generalized anxiety and depression in patients with primary brain tumors. J Neuro-Oncol 10:171–181
Goebel S, Strenge H, Mehdorn HM (2011) Acute stress in patients with brain cancer during primary care. Support Care Cancer 20(7):1425–1434
Pace A, Metro G, Fabi A (2010) Supportive care in neurooncology. Curr Opin Oncol 22(6):621–626
Rooney AG, Carson A, Grant R (2011) Depression in cerebral glioma patients: a systematic review of observational studies. J Natl Cancer Inst 103(1):61–76
D'Angelo C, Mirijello A, Leggio L, Ferrulli A, Carotenuto V, Icolaro N, Miceli A, D'Angelo V, Gasbarrini G, Addolorato G (2008) State and trait anxiety and depression in patients with primary brain tumors before and after surgery: 1-year longitudinal study. J Neurosurg 108(2):281–286
Litofsky NS, Farace E, Anderson F, Meyers CA, Huang W, LE R (2004) Depression in patients with high-grade glioma: results of the glioma outcome project. Neurosurgery 54:358–366
Mainio A, Hakko H, Niemela A, Koivukangas J, Rasanen P (2005) Depression and functional outcome in patients with brain tumours: a population based 1-year follow-up study. J Neurosurg 103:841–847
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370
Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale—an updated literature review. J Psychosom Res 52:69–77
Karnofsky DA, Burchenal JH (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM (ed) Evaluation of chemotherapeutic agents. Columbia Universitiy Press, New York, pp 191–205
Krannich JH, Weyers P, Lueger S, Herzog M, Bohrer T, Elert O (2007) Presence of depression and anxiety before and after coronary artery bypass graft surgery and their relationship to age. BMC Psychiatry 7:47
Hinz A, Zweynert U, Kittel J, Igl W, Schwarz R (2009) Measurement of change with the Hospital Anxiety and Depression Scale (HADS): sensitivity and reliability of change. Psychother Psychosom Med Psychol 59:394–400
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376
Schumacher J, Klaiberg A, Brähler E (2003) Diagnostische Verfahren zu Lebensqualität und Wohlbefinden. Hogrefe, Göttingen
Foa EB (1997) Posttraumatic Stress Diagnostic Scale (PDS®). Pearson, San Antonio
Fydrich T, Sommer G, Brähler E (2007) F-SozU-Fragebogen zur Sozialen Unterstützung. Hogrefe, Göttingen
Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New York
Warrington EK, James M (1992) Testbatterie für visuelle Objekt-und Raumwahrnehmung (VOSP). Thames Valley Test Company, Bury St Edmunds
Wechsler D (1987) Wechsler Memory Scale-Revised. The Psychological Corporation, San Antonio
Benton AL, Kd H (1989) Multilingual aphasia examination. AJA Associates, Iowa City
Huber W, Poeck K, Weninger D, Willmes K (1983) Der Aachener Aphasie Test (AAT). Hogrefe, Göttingen
Leonhart R (2004) Effektgrößenberechnung bei Interventionsstudien. Die Rehabil 43:241–246
Leplow B, Friege L (1998) Eine Sozialformel zur Schätzung der prämorbiden Intelligenz. Z Klin Psychol 27:1–8
Hinz A, Krauss O, Hauss JP, Höckel M, Kortmann RD, Stolzenburg JU, Schwarz R (2009) Anxiety and depression in cancer patients compared with the general population. Eur J Cancer Care 19:522–529
Mainio A, Hakko H, Timonen M, Niemelä A, Koivukangas J, Räsänen P (2005) Depression in relation to survival among neurosurgical patients with primary brain tumor: a 5-year follow-up study. Neurosurgery 56:1234–1242
Ownsworth T, Hawkes A, Steginga S, Walker D, Shum D (2009) A biopsychosocial perspective on adjustment and quality of life following brain tumor: a systematic evaluation of the literature. Disabil Rehabil 31:1038–1055
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
Goebel S, Kaup L, Mehdorn HM (2011) Measuring preoperative anxiety in patients with intracranial tumours: the Amsterdam Preoperative Anxiety and Information Scale (APAIS). J Neurosurg Anesthesiol 23(4):297–303
Gupta DK, Chandra PS, Ojha BK, Sharma BS, Mahapatra AK, Mehta VS (2007) Awake craniotomy versus surgery under general anesthesia for resection of intrinsic lesions of eloquent cortex—a prospective randomised study. Clin Neurol Neurosurg 109:335–343
Janda M, Steginga S, Langbecker D, Dunn J, Walker D, Eakin E (2007) Quality of life among patients with a brain tumour and their carers. J Psychosom Res 63:617–623
Armstrong C, Goldstein B, Cohen B, Jo M, Tallent E (2002) Clinical predictors of depression in patients with low-grade brain tumors: consideration of a neurologic versus a psychogenic model. J Clin Psychol Med Settings 9(2):97–107
Wellisch DK, Kaleita TA, Freeman D, Cloughesy T, Goldman J (2002) Predicting major depression in brain tumor patients. Psycho-Oncology 11:230–238
Salander P, Bergenheim T, Henriksson R (1996) The creation of protection and hope in patients with malignant brain tumours. Soc Sci Med 42(7):985–996
Pelletier G, Verhoef MJ, Khatri N, Hagen N (2002) Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. J Neuro Oncol 57:41–49
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 14:410–416
Conflicts of interests
None. We have full control of all primary data and agree to let the journal review the data if requested.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Goebel, S., Mehdorn, H.M. Development of anxiety and depression in patients with benign intracranial meningiomas: a prospective long-term study. Support Care Cancer 21, 1365–1372 (2013). https://doi.org/10.1007/s00520-012-1675-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-012-1675-5