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Abstract

Neuropsychiatric problems, and how they interact to impact on quality of life (QOL) in brain tumor patients, are generally poorly understood. The objectives of this study were: (1) to document the prevalence of depression, fatigue, emotional distress, and existential issues in a sample of brain tumor patients (2) to examine the interconnectedness of these problems, and (3) to explore their relationship with disease-related variables and QOL. This is a cross-sectional, questionnaire-based survey of 73 patients with primary brain tumors who presented to a neurological clinic at a tertiary cancer centre for ongoing care. Data for 60 participants (29 women, 31 men) who completed validated questionnaires were retained for analysis. Results showed that there was a high burden of depressive symptoms as measured by the Beck Depression Inventory-II (mean score 11.1, SD 7.4), with 38% of the sample scoring in the clinically depressed range. Overall QOL scores for this sample were similar to a reference sample of brain tumor patients. The scores on the existential subscale of the McGill Quality of Life questionnaire were comparable to those of a reference sample of cancer patients receiving ongoing care (mean score 7.2; SD 1.7). Fifty per cent of the sample could be classified as struggling with existential issues. Although scores reflecting depression, fatigue, emotional distress, and existential problems were interrelated, the presence of depressive symptoms was the single most important independent predictor of QOL in this cohort of brain fumor patients. Implications for treatment are discussed.

Distress and quality of life in primary high-grade brain tumor patients

“…In symptom cluster analysis, depression explained 26% of the variance in quality of life, and 56% of the variance in functional status in brain cancer patients [5]. Similarly, Pelletier et al found that the presence of depressive symptoms was the most significant predictor of quality of life in a sample of brain tumor patients [19]. This study did not utilize a discreet instrument for psychosocial distress, but utilized emotional distress as measured by the FACT-Br.…”

“…The disease process itself contributes to fatigue, and brain tumor patients are highly likely to receive treatments, such as cranial irradiation, that are associated with high levels of fatigue. Fatigue has been noted in a number of studies in highgrade-glioma patients [1,19]. Depression has a high prevalence among patients with brain cancer, with depressive symptoms in one study being reported by 69 (95%) of 73 participants [5].…”

Distress persists in long-term brain tumor survivors with glioblastoma multiforme

“…To further complicate this situation, patients must almost immediately make choices and decisions about complex treatment plans. Other issues that present challenges to survivors of brain tumors are fatigue and loss of stamina resulting from irradiation and chemotherapy, seizures and their treatments (anticonvulsants) which have been known to impact patient cognition [17], enormous financial drain due to loss of employment/ insurance coverage and medications not covered by insurance [18], one's ability to drive is often suspended which impacts patients' independence and often increases the sense of burden on social network, changes in body image due to corticosteroid use-cushingoid appearance along with weight gain, tensions in intimate relationships, changes in personality and behavior associated with mild brain injury, and symptoms suggestive of clinical depression [19]. To further complicate the experience, the prognosis for GBMs is poor relative to other cancers and even other types of brain tumors [1,2].…”

Psychiatric symptoms in glioma patients: from diagnosis to management

“…Mood issues that are potentially treatable may then be overlooked and undertreated 66. This can have serious negative consequences for glioma patients’ quality of life,67 and even their morbidity and survival 47,68…”