Psychiatric Symptoms Associated with Brain Tumors: A Clinical Enigma

Abstract

Patients in psychiatric settings may present with medical conditions, such as brain tumors, which may or may not be associated with neurological symptoms. In some cases, patients may only have psychiatric symptoms, such as mood changes (depression or mania), psychotic symptoms, panic attacks, changes in personality, or memory difficulties. Brain tumors may be detected in patients at their first presentation to mental health services or sometimes in patients with well-established psychiatric diagnoses.This article presents the case of a 29-year-old woman who was treated for >4 years for posttraumatic stress disorder and borderline personality traits, who developed depressive symptoms and memory difficulties. However, she did not develop any major neurological signs or symptoms. Brain imaging showed the presence of a left thalamic tumor, later confirmed as glioblastoma multiforme. She underwent surgical treatment and radiation therapy. With this we show that in some cases, brain tumors can be neurologically silent and only present atypical psychiatric symptoms.

Frontal meningioma presenting as depressive episode: case report and a brief review of literature

“…(12) The psychiatric manifestations commonly seen are depression, mania, psychosis, anxiety, apathy, cognitive or personality changes etc. (13) Different factors affect the clinical presentation of the patient with a brain tumour i.e. the rate of growth of the tumour, tumours producing raised intracranial tension, location of the tumour, tumour type and premorbid intelligence.…”

Neuroimaging in Psychiatric Disorders

“…In some cases, a behavioral syndrome is caused by focal seizures arising from a tumor, notably oligodendroglioma, or from congenital or traumatic lesions [4, 5]. Psychotic features may also be found with thalamic or hypothalamic lesions [6, 7]. Apathy caused by a frontal brain tumor may be mistaken for depression [8].…”

Tumor Locus Moderates Anxiety Symptoms in a Pediatric Neuro-Oncologic Sample

“…Perhaps to control for variability in tumor-related damage and complex clinical factors, examining correlates of anxiety in patients with CNS tumors has focused on single case studies, primarily in adults (e.g., Caplan, Comair, Jackson, Chugani, & Peacock, 1992;Gamazo-Garran, Soutullo, & Ortuno, F., 2002;John, Eapen, & Shaw, 1997;Moise & Madhusoodanan, 2006;Peterson, Bronen, & Duncan, 1996). These studies lack generalizability, particularly to the child population.…”