The aims of this prospective study were to investigate levels of anxiety and depression in patients with a solitary intracranial neoplasm before and after surgery, and to determine if relationships exist between high levels of anxiety or depression and the hemispheric location of the tumour, the tumour type or patient gender. Patients aged between 17 and 79 years with a solitary intracranial neoplasm completed the Hospital Anxiety and Depression Scale (HAD) before and after biopsy or resective tumour surgery. A control group of non-brain-damaged subjects also completed the HAD before and after lumbar spinal surgery. Of the 109 patients with a brain tumour 30 and 16% demonstrated the likely presence of anxiety and depression, respectively, according to HAD scoring criteria. A greater proportion of females with a left hemisphere tumour reported higher levels of emotional disturbance than any other group of patients; relationships between dysphasia and levels of anxiety or depression were not significant. Patients with a meningioma had higher levels of anxiety and depression as measured by the HAD than those with any other tumour types. Levels of both anxiety and depression were significantly lower after tumour surgery according to the HAD. There were no significant differences in HAD scores between (a) left and right hemispheric tumour groups, and (b) the tumour and control (n = 20) groups. This study has found that anxiety and depression as measured by the HAD are relatively uncommon in patients with an intracranial neoplasm, and that levels of mood disturbance do not differ significantly from those in patients undergoing lumbar spinal surgery. Levels of anxiety and depression become lower after surgery in patients with a brain tumour. Patterns of anxiety and depression in patients with a brain tumour appear to differ from those reported in stroke.

These results, are very similar to a previous American report using a different anesthetic technique, in that most patients tolerate awake craniotomy remarkably well if the procedure is explained to them and some simple precautions are taken. Additionally between 8%-37% of patients (95% Confidence Interval, summing data from the two studies, n = 35) will have no recollection of being awake. Ways of minimising discomfort and problems of anxiety in this patient cohort are discussed.

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The findings from this study indicate that although there are clearly common perspectives, the views of people with aphasia about services do not necessarily coincide with those of service providers. This is an important consideration when initiating consultation and highlights the need for clarity on the part of practitioners in identifying the aims and objectives of their services as far as people with aphasia are concerned.

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