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Suicidal ideation, depression, and health-related quality of life in patients with benign and malignant brain tumors: a prospective observational study in 83 patients

  • Clinical Article - Brain Tumors
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Abstract

Objective

Health-related quality of life (HRQoL) and psychosocial burden are of relevance in patients with intracranial tumors. We investigated the prevalence of suicidal ideation (SI), depression, and their association with HRQoL in patients with intra- (IA) and extraaxial (EA) tumors during the first 9 months after diagnosis.

Methods

Patients were recruited immediately following surgery, and re-evaluated after 3, 6, and 9 months (EORTC QLQ-C30/BN20, Beck Depression Inventory (BDI) and Appendix). Patients with a personal history of psychological comorbidity were excluded. Sociodemographic and clinical data were evaluated.

Results

IA patients had lower functioning scores and experienced more symptoms. Global Health Status was significantly lower at baseline (p = 0.038), but improved over time (p < 0.001). Seventeen patients (21.5 %) admitted to having had SI at least once during the study period (IA: n = 10/EA: n = 7). The highest rates were observed after 6 (IA: 18.8 %) and 9 months (EA: 10.0 %). Patients reporting SI had significantly higher BDI scores [p = 0.22 (baseline), p = 0.031 (3 months), p < 0.001 (6 months)]. After 6 months, HRQoL differed greatest between patients with and without SI. Most patients experienced good familial support (76 %).

Conclusions

Patients with intracranial tumors suffer from decreased HRQoL and SI regardless of histopathology. SI is associated with higher BDI scores, but not evident depression (BDI ≥ 18). Thus, patients should be screened specifically and regularly. Lower HRQoL and greatest prevalence of SI at 6 months may help clinicians to find the right time for careful monitoring of patients at risk.

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Acknowledgments

We thank Dr. Claudia Sassenrath for her supervision when planning the study design and phrasing the Appendix questions. We thank Stephan Kindel for revising and improving the quality of the presented artwork.

Author information

Authors and Affiliations

  1. Center for Endoscopic and Minimally Invasive Neurosurgery, Hirslanden, Witellikerstrasse 40, 8032, Zurich, Switzerland

    Anne-Katrin Hickmann

  2. Department of Neurosurgery Klinikum Stuttgart, Katharinenhospital, Stuttgart, Germany

    Anne-Katrin Hickmann, Minou Nadji-Ohl, Markus Haug, Nikolai J. Hopf, Oliver Ganslandt & Mirjam Renovanz

  3. Neurochirurgicum, Center for Endoscopic and Minimally Invasive Neurosurgery, Stuttgart, Germany

    Nikolai J. Hopf

  4. Department of Neurosurgery, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany

    Alf Giese & Mirjam Renovanz

Authors
  1. Anne-Katrin Hickmann
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  2. Minou Nadji-Ohl
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Correspondence to Anne-Katrin Hickmann.

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Funding

No funding was received for this research.

Conflict of interest

The author(s) declare that they have no competing interests

Ethical approval

This study was performed in accordance with national law, institutional ethical standards, and the Helsinki Declaration and its later amendments, after its approval by the local ethics committee (F-2010-030).

Informed consent

Prior to the first assessment all patients gave their written informed consent.

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Fig. 4

Individual change in GHS, BDI, and SI over time (IA vs. EA) – supplement. a–c GHS, BDI and SI in patients with intraaxial tumors. d–f GHS, BDI and SI in patients with extraaxial tumors (JPG 1580 kb)

Appendix: self-constructed questions

Appendix: self-constructed questions

Familial support

My family is very supportive in this special situation and helps me keep my spirits up.

  1. 0)

    True, I can always count on my family.

  2. 1)

    Rather true, most of the time.

  3. 2)

    Rather not true, I feel alone often.

  4. 3)

    False, I am alone.

Suicidal ideation

  1. 0)

    Correct, I have already thought about specific plans.

  2. 1)

    Rather true, I am occasionally thinking about it, but I have never made any plans.

  3. 2)

    Rather not true, I am sad, but I have never thought about it.

  4. 3)

    False, I never think about it.

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Hickmann, AK., Nadji-Ohl, M., Haug, M. et al. Suicidal ideation, depression, and health-related quality of life in patients with benign and malignant brain tumors: a prospective observational study in 83 patients. Acta Neurochir 158, 1669–1682 (2016). https://doi.org/10.1007/s00701-016-2844-y

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