Depression and anxiety in glioma patients

Abstract

Glioma patients carry the burden of having both a progressive neurological disease and cancer, and may face a variety of symptoms, including depression and anxiety. These symptoms are highly prevalent in glioma patients (median point prevalence ranging from 16% to 41% for depression and 24% to 48% for anxiety when assessed by self-report questionnaires) and have a major impact on health-related quality of life and even overall survival time. A worse overall survival time for glioma patients with depressive symptoms might be due to tumor progression and/or its supportive treatment causing depressive symptoms, an increased risk of suicide or other (unknown) factors. Much is still unclear about the etiology of depressive and anxiety symptoms in glioma. These psychiatric symptoms often find their cause in a combination of neurophysiological and psychological factors, such as the tumor and/or its treatment. Although these patients have a particular idiosyncrasy, standard treatment guidelines for depressive and anxiety disorders apply, generally recommending psychological and pharmacological treatment. Only a few non-pharmacological trials have been conducted evaluating the efficacy of psychological treatments (e.g., a reminiscence therapy-based care program) in this population, which significantly reduced depressive and anxiety symptoms. No pharmacological trials have been conducted in glioma patients specifically. More well designed trials evaluating the efficacy of (non-)pharmacological treatments for depressive and anxiety disorders in glioma are urgently needed to successfully treat psychiatric symptoms in brain tumor patients and to improve (health-related) quality of life.

High costs, low quality of life, reduced survival, and room for improving treatment: an analysis of burden and unmet needs in glioma

“…Glioma affects patients’ functional status and HRQoL negatively, due to disease- and therapy-related symptoms such as neurocognitive deficits, including visual disorders and communication deficits, disturbed sleep, fatigue, drowsiness, itchy skin, and bladder control issues, and due to associated conditions such as depression and anxiety ( Table 1 ) ( 3 , 46 – 49 , 66 ). Concerns about HRQoL are the main factor in treatment decisions for up to 81% of patients, of whom 81% and 79% – for low- and high-grade glioma, respectively – are primarily concerned with quality of life, not survival, when deciding on treatment ( 52 ).…”

Unmet needs in people with high-grade glioma: defining criteria for stepped care intervention

“…After those with lung cancer, people with brain tumor (PwBT) have a higher prevalence of symptom burden and concerns and more severe problems, relative to other cancer types ( 7 ). Additionally, PwBT commonly experience a poorer sense of wellbeing and quality of life ( 8 ), with 16%-48% reporting clinical levels of anxiety or depression ( 9 ). The high symptom burden results in higher health service costs for individuals and the healthcare system, rendering it one of the costliest cancers ($1.7 million/person) ( 10 ).…”