Gupta Ramesh K, Kumar Rajeev
Mental Health Service, Phillip Health Centre, Woden, Canberra, Austalian Capital Territory, Australia.
Aust N Z J Psychiatry. 2004 May;38(5):316-9. doi: 10.1080/j.1440-1614.2004.01357.x.
To examine the psychiatric comorbidity in benign brain tumours.
A retrospective (5 years) data analysis at our 500 bed teaching hospital. The diagnoses of benign brain tumours were based on the record of final diagnoses in the case records confirmed by either CT or MRI scans. Case records of patients with clearly documented history of psychiatric symptoms of several weeks to several months duration were identified only if such symptoms had antedated a diagnosis of the brain tumour. Using a specially designed proforma, two psychiatrists rated the symptoms together. We also collected data on age, gender and CT/MRI findings. Consensus was reached on all cases in regard to the psychiatric phenomenology. The symptoms were divided according to their presentation into purely neurological or psychiatric symptoms.
A total of 79 patients were identified as having a primary diagnosis of benign brain tumour. There were 56 female patients and 23 male patients. Seventy-two of these had meningiomas. Fifteen (21%) of 72 meningioma cases, eight men and seven women, presented with psychiatric symptoms in the absence of neurological symptoms. Affective disorders were a common presentation. There was no correlation between brain laterality and the psychiatric comorbidity.
Psychiatric symptoms may be the only initial manifestations of meningiomas of the brain in a significant number of cases occurring in the fifth decade of life. Such patients must be investigated by brain imaging studies even if there are no neurological signs or symptoms.
研究良性脑肿瘤中的精神疾病共病情况。
在我们拥有500张床位的教学医院进行一项回顾性(5年)数据分析。良性脑肿瘤的诊断基于经CT或MRI扫描确诊的病例记录中的最终诊断记录。仅当精神症状早于脑肿瘤诊断时,才确定有明确记录的持续数周至数月精神症状病史的患者的病例记录。两名精神科医生使用专门设计的表格共同对症状进行评分。我们还收集了年龄、性别和CT/MRI检查结果的数据。就所有病例的精神现象学达成了共识。症状根据其表现分为单纯神经症状或精神症状。
共有79名患者被确诊为原发性良性脑肿瘤。其中有56名女性患者和23名男性患者。这些患者中有72人患有脑膜瘤。在72例脑膜瘤病例中,有15例(21%),8名男性和7名女性,在没有神经症状的情况下出现了精神症状。情感障碍是常见的表现形式。脑的左右侧性与精神疾病共病之间没有相关性。
在大量发生于生命第五个十年的病例中,精神症状可能是脑脑膜瘤的唯一初始表现。即使没有神经体征或症状,此类患者也必须接受脑成像检查。