Kang Xiaoman, Ge Yulu, Zhang Xin, Yang Tianrui, Xia Yu, Wang Yaning, Li Junlin, Chen Wenlin, Zhang Kun, Xiao Zhiyuan, Wu Jiaming, Song Yixuan, Cao Yaning, Dong Yijun, Wang Yuekun, Xing Hao, Guo Xiaopeng, Wang Yu, Ma Wenbin
Department of Neurosurgery, Center for Malignant Brain Tumors, National Glioma MDT Alliance, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
'4+4' Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Neurosurg Rev. 2024 Dec 28;48(1):10. doi: 10.1007/s10143-024-03169-3.
Brain tumors are associated with a dismal prognosis, and the diagnosis often evokes significant psychological distress. However, the progression of emotional well-being throughout the clinical course of brain tumors remains poorly understood. This study aims to assess the prevalence of anxiety and depression in brain tumor patients and to identify the risk factors associated with postoperative emotional derangement in glioma and metastatic groups seperately. Psychological conditions were evaluated using the Hospital Anxiety and Depression Scale (HADS) at various preoperative and postoperative time points. A total of 159 patients who underwent surgery and HADS assessment between May 2018 and November 2020 were included in the analysis, comprising 112 glioma patients and 47 metastatic brain tumor patients. After surgery, the incidence of anxiety and depression increased in both the glioma and the metastatic brain tumor group. In both groups, tumors involving the frontal lobe were associated with a significant increase in postoperative HADS depression scores, whereas involvement of other lobes did not significantly affect postoperative HADS scores. Additionally, postoperative HADS scores did not differ significantly among gliomas of different grades. Among glioma patients, univariate analysis indicated that left-sided tumors were associated with an increased risk of postoperative depression worsening. In the metastatic group, a BMI > 24 was identified as a risk factor for postoperative anxiety exacerbation. The findings from this study highlight clinical characteristics associated with a higher risk of postoperative psychological disturbance, aiding in early prevention and tailored care to improve the quality of life for patients with intracranial tumors.
脑肿瘤的预后不佳，其诊断往往会引发严重的心理困扰。然而，人们对脑肿瘤临床病程中情绪健康状况的变化仍知之甚少。本研究旨在评估脑肿瘤患者焦虑和抑郁的发生率，并分别确定胶质瘤组和转移瘤组术后情绪紊乱的相关危险因素。在术前和术后的不同时间点，使用医院焦虑抑郁量表（HADS）对心理状况进行评估。共有159例在2018年5月至2020年11月期间接受手术并进行HADS评估的患者纳入分析，其中包括112例胶质瘤患者和47例转移性脑肿瘤患者。术后，胶质瘤组和转移性脑肿瘤组的焦虑和抑郁发生率均有所上升。在两组中，累及额叶的肿瘤与术后HADS抑郁评分显著升高相关，而累及其他脑叶则对术后HADS评分无显著影响。此外，不同分级的胶质瘤术后HADS评分无显著差异。在胶质瘤患者中，单因素分析表明左侧肿瘤与术后抑郁加重风险增加有关。在转移瘤组中，BMI>24被确定为术后焦虑加重的危险因素。本研究结果突出了与术后心理障碍高风险相关的临床特征，有助于早期预防和个性化护理，以提高颅内肿瘤患者的生活质量。
