The relevant psychological burden of having a benign brain tumor: a prospective study of patients undergoing surgical treatment of cranial meningiomas

Abstract

OBJECTIVEMeningiomas are the most common intracranial neoplasm. Evidence concerning surgical management and outcome is abundant, while the implications for the quality of life (QOL) of a patient confronted with the diagnosis and undergoing surgery are unclear. The authors conducted a prospective study to evaluate QOL in relation to psychological comorbidities comorbidities.METHODSA prospective study of patients undergoing elective surgery for the removal of an intracranial meningioma was performed. The authors evaluated depression (Allgemeine Depressionsskala K score) and anxiety (Post-Traumatic Stress Scale–10 [PTSS-10]; State Trait Anxiety Inventory–State Anxiety and –Trait Anxiety [STAI-S and STAI-T]; and Anxiety Sensitivity Index–3 [ASI-3]) scores before surgery and at 3 and 12 months after surgery. The correlation between preoperative psychological burden and postoperative QOL as measured by the 36-Item Short Form Health Survey and EQ-5L questionnaires was analyzed. Incidence and influence of these psychiatric comorbidities on clinical outcome were examined.RESULTSA total of 78 patients undergoing resection of a meningioma between January 2013 and September 2017 participated in the preoperative psychological screening and 71 patients fully completed postoperative follow-up examination after 1 year of follow-up. At presentation, 48 patients (67.7%) had abnormal anxiety scores, which decreased to 29.6% (p = 0.003). On follow-up at 12 months, mean EQ-5L visual analog scale scores were significantly lower in patients with pathological scores on the PTSS-10 (0.84 vs 0.69; p = 0.004), STAI-S (0.86 vs 0.68; p = 0.001), and STAI-T (0.85 vs 0.71; p = 0.011). Neurological status (modified Rankin Scale) improved slightly and showed some correlation with psychological comorbidities QOL scores (p = 0.167). There was a nonsignificant increase of EQ-5L scores over the period of follow-up (p = 0.174) in the repeated-measures analysis. In the regression analysis, impaired QOL and physical disability on follow-up correlated with elevated preoperative anxiety and depression levels.CONCLUSIONSThe QOL and physical disability of patients undergoing resection of an intracranial meningioma highly depend on preoperative anxiety and depression levels. Stress and anxiety scores generally decrease after the resection, which leads us to conclude that there is a tremendous emotional burden caused by an upcoming surgery, necessitating close psychooncological support in order to uphold functional outcome and health-related QOL in the postoperative course.

Psychological Burden in Meningioma Patients under a Wait-and-Watch Strategy and after Complete Resection Is High—Results of a Prospective Single Center Study

“…In our study, the values of the physical health component of SF-36 were comparable to the values reported in meningioma patients before and after surgical treatment [13]. After meningioma surgery, patients generally report lower HRQoL compared to healthy controls [8,18], although some data on patients who underwent surgery for asymptomatic meningiomas demonstrated no significant difference compared to the general population [19,20].…”

“…A study examining patients with meningiomas and schwannomas of cerebellopontine angle under a watch-and-wait strategy reported clinically relevant levels of anxiety and depression in one-third of patients [16]. The proportion of anxiety and depression in our cohort was higher in comparison to comparison to other studies [12][13][14][15][16]. This might reflect some regional differences.…”

“…The few existing studies on depression and anxiety in meningioma patients demonstrate increased levels of distress in comparison to the general population-the proportion of patients with abnormal HADS-A scores reached 70%, and for HADS-D, 30% in operated patients [12][13][14][15]. In most cases, symptoms declined after the operation.…”

Psychological predictors of quality of life after anterior cervical discectomy and fusion for degenerative cervical spine disease

“…We applied a similar methodology as studies concerning this topic previously published by our study group by prospectively screening patients scheduled for elective ACDF at our institution 19,20 . Our preoperative assessment encompassed various scales of depression and anxiety disorders, which we sought to identify via the following commonly employed psychological instruments: the Center for Epidemiological Studies Depression Scale 21,22 (Allgemeine Depressionsskala; ADS), Post-Traumatic Stress Scale-10 23 24 (STAI-T) and Anxiety Sensitivity Index-3 25,26 (ASI).…”

Psychiatric and cognitive correlates of quality of life among persons with primary brain tumors

“…Quality of life (QOL) as an important outcome measure has been studied recently with psychiatric correlates and cognitive functions, though research required for generating evidence-based clinical practice still remains inconclusive. [1516] Osoba et al . studied the effect of burden of the disease due to recurrence on QOL and found that the patients with glioblastoma multiforme or anaplastic astrocytoma had comparable QOL, though recurrent high-grade glioma had lower QOL scores than other localized ovarian and lung cancer.…”