Depression among adult patients with primary brain tumour: a cross-sectional study of risk factors in a low–middle-income country

Abstract

ObjectiveThe prevalence of depression among patients with primary brain tumour ranges from 15% to 40% globally. Several individual and clinical factors contribute to the development of depression. However, their association with depression in Pakistani setting has not yet been assessed. Thus, we aim to study the factors associated with depression among adult patients with primary brain tumour at a tertiary care hospital in Karachi, Pakistan.Study designA prospective cross-sectional study.SettingThis study was conducted at a tertiary care hospital of Karachi, Pakistan.ParticipantsThis study included 132 patients with confirmed diagnosis of primary brain tumour (initially diagnosed on MRI of the brain with contrast and later confirmed on histology of surgical specimen) in various stages of treatment.Primary outcomeThe primary outcome of this study was to assess depression and its associated factors among adult patients with primary brain tumour. Depression was assessed using a validated screening tool Patient Health Questionnaire-9 (PHQ-9). Scores of 10–27 on PHQ-9 were indicative of screen positive for depressive symptoms. A set of the structured pre-tested questions was used to evaluate patient-related, tumor-related and treatment-related factors.ResultsFifty-one (39%, CI: 33.33–46.94) patients in our study screened positive for depressive symptoms on PHQ-9. There was a significant association between depressive symptoms and Karnofsky Performance Scores (KPS) (prevalence ratio: 3.25 and CI: 1.87–5.62) after controlling covariates. Propensity scores predicted a positive association between KPS (functional status) and unemployment, treatment stage, and tumour recurrence. Tumor-related and treatment-related factors including tumour grade, location, type and hemispheric lateralisation were found insignificant.ConclusionDepression is common in patients with primary brain tumour. Impaired functional status has a direct impact on depression in these patients. Incorporating the psychosocial domain earlier in the course of treatment needs to be considered for better neuro-oncology management of patients with primary brain tumour.

Patients With Hemangioblastoma: Mood Disorders and Sleep Quality

“…In the study conducted by Pidani et al [ 24 ] in Pakistan, 51 patients with brain tumors were examined. The findings indicated that depression is a common occurrence among individuals with primary brain tumors and directly affects their functional status, which aligns with the results of the current investigation.…”

Chronic stress as an emerging risk factor for the development and progression of glioma

“…[ 18 , 19 ] Furthermore, a patient’s mental health problems worsen further during surgery and treatment. [ 20 , 21 ] Other cohort and clinical studies have also shown that depression is an important prognostic factor for the survival of glioma patients. Compared to HGG group without depression, HGG patients with depression have shorter overall survival.…”

Psychosocial factors influencing quality of life in patients with primary brain tumors in Pakistan: an analytical cross-sectional study

“…Patients with primary brain tumors (PBTs) often suffer from clinically significant psychological distress [ 1 ], the levels of which are higher than that experienced by patients suffering from most other types of malignancies [ 2 ]. Common mental health problems include depression, anxiety, stress, adjustment disorder and post-traumatic stress disorder, in addition to mental and emotional fatigue [ 2 , 3 , 4 ].…”

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