PAPER

The effect of brain tumour laterality on anxiety levels among neurosurgical patients

A Mainio¹, H Hakko¹, A Niemelä¹, T Tuurinkoski², J Koivukangas² and P Räsänen¹

¹ Department of Psychiatry, University of Oulu, Finland
² Department of Neurosurgery, Oulu University Hospital, Finland

Correspondence to:
Correspondence to:
Dr Mainio, Department of Psychiatry, Oulu University Hospital, BOX 26, 90029 OYS, Finland;
arja.mainio{at}ppshp.fi

Objectives: The aim of this study was to investigate the level of anxiety in patients with a primary brain tumour and to analyse the effect of tumour laterality and histology on the level of anxiety. Recurrent measurements were assessed preoperatively, three months, and one year after operation.

Methods: The study population consisted of 101 patients with a primary brain tumour from unselected and homogeneous population in northern Finland. The patients were studied preoperatively with CT or MRI to determine the location of the tumour. The histology of the tumour was defined according to WHO classification. The level of anxiety was obtained by Crown-Crisp Experiential Index (CCEI) scale.

Results: The patients with a tumour in the right hemisphere had statistically significantly higher mean anxiety scores compared to the patients with a tumour in the left hemisphere before surgery of the tumour. By three months and by one year after surgical resection of the tumour, the level of anxiety declined in patients with a tumour in the right hemisphere. A corresponding decline was not found in patients with a tumour in the left hemisphere. According to laterality by tumour histology, the level of anxiety decreased significantly in male and female patients with a glioma in the right hemisphere, but a corresponding decline was not significant in the female patients with a meningioma in the right hemisphere. Decreased level of anxiety was not found in patients with gliomas or meningiomas in the left hemisphere by follow up measurements.

Conclusions: Primary brain tumour in right hemisphere is associated with anxiety symptoms. The laterality of anxiety seems to reflect the differentiation of the two hemispheres. The level of anxiety declined after operation of right tumour, approaching that of the general population. The effect of right hemisphere gliomas on anxiety symptoms deserves special attention in future research.

Keywords: brain tumour; anxiety; laterality

Abbreviations: CCEI, Crown-Crisp Experiential Index; CT, computer tomography; FFA, free floating anxiety; HAD, Hospital Anxiety and Depression Scale; MRI, magnetic resonance imaging

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