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Clinical Predictors of Depression in Patients with Low-Grade Brain Tumors: Consideration of a Neurologic Versus a Psychogenic Model

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Abstract

Few studies have examined quality of life issues in patients with brain tumors, though coping with cancer is stressful and is associated with heightened levels of depression. We used regression to examine the clinical factors that might predict depression in a group of 57 adults with low-grade brain tumors after surgery but prior to radiotherapy and chemotherapy. A neurological model comprised of tumor characteristics and treatment was compared with a psychogenic model comprised of both psychosocial and psychodynamic variables. Demographic variables and level of fatigue were also included. A model consisting primarily of fatigue (also clinically elevated) and secondarily of tumor location and aggressiveness of surgical treatment accounted for 33% of the depression score. In a small group at a later follow-up when patient depression was clinically elevated (4–6 years after baseline), fatigue, female sex, cognitive dysfunction, increased family support, and increased report of physical symptoms were associated with depression. The late out findings remain exploratory because of the small sample size, but they suggest that depression develops over time and results from a combination of neurological and psychosocial problems that ensue initial treatments. Treating these collateral problems may reduce the complications from depression.

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REFERENCES

  • Armstrong, C., Corn, B., Ruffer, J., Pruitt, A., Mollman, J., & Phillips, P. (2000). Radiotherapeutic effects on brain function: Double dissociation of memory systems. Neuropsychiatry, Neuropsychology, Behavioral Neurology, 13, 101–111.

    Google Scholar 

  • Beblo, T., Wallesch, C.-W., & Herrmann, M. (1999). The crucial role of frontostriatal circuits for depressive disorders in the postacute stage after stroke. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 12, 236–246.

    Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.

    Google Scholar 

  • Butcher, J. N., Dahlstrom, W. G., Graham, J. R., Tellegen, A., & Kaemmer, B. (1989). Manual for the restandardized Minnesota Multiphasic Personality Inventory: MMPI-2. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Canning, E. H., Canning, R. D., & Boyce, W. T. (1992). Depressive symptoms and adaptive style in children with cancer. Journal of the American Academy of Child and Adolescent Psychiatry, 311120–1123.

    Google Scholar 

  • Colantonia, A., Kasl, S.V., Ostfeld, A. M., & Berkman, L. F. (1993). Psychosocial predictors of stroke outcomes in an elderly population. Journal of Gerontology, 48, S261–S268.

    Google Scholar 

  • Crossen, J. R., Garwood, D., Glatstein, E., & Neuwelt, E. A. (1994). Neurobehavioral sequelae of cranial irradiation in adults: Areview of radiation-induced encephalopathy. Journal of Clinical Oncology, 12, 627–642.

    Google Scholar 

  • Derogatis, L. R., Morrow, G. R., Fetting, J., Penman, D., Piasetsky, S., Schmale, A. M., et al. (1983). The prevalence of psychiatric disorders among cancer patients. JAMA, 249(6), 751–757.

    Google Scholar 

  • Drachman, D., Glosser, G., Fleming, P., & Longenecker, G. (1982). Memory decline in the aged: Treatment with lecithin and physostigmine. Neurology, 32, 944–950.

    Google Scholar 

  • Fassbender, K., Schmidt, R., Mofsner, R., Kischka, U., Kuhnen, J., Schwartz, A., et al. (1998). Mood disorders and dysfunction of the hypothalamic-pituitary-adrenal axis in multiple sclerosis: Association with cerebral inflammation. Archives of Neurology, 5566–72.

    Google Scholar 

  • Finset, A., Goffeng, L., Landro, N. I., & Haakonsen, M. (1989). Depressed mood and intra-hemispheric location of lesion in right hemisphere stroke patients. Scandinavian Journal of Rehabilitation Medicine, 21, 1–6.

    Google Scholar 

  • Fisk, J. L., & Del Dotto, J. E. (1990). Neuropsychological sequelae of brain tumors. Henry Ford Hospital Medical Journal, 38, 213–218.

    Google Scholar 

  • Giovagnoli, A. R. (1999). Quality of life in patients with stable disease after surgery, radiotherapy, and chemotherapy for malignant brain tumour. Journal of Neurology, Neurosurgery, and Psychiatry, 67, 358–363.

    Google Scholar 

  • Glass, T. A., Matchar, D. B., Belyea, M., & Feussner, J. R. (1993). Impact of social support on outcome in first stroke. Stroke, 24, 64–70.

    Google Scholar 

  • Greene, R. L. (1991). The MMPI-2/MMPI: An interpretive manual. Boston: Allyn and Bacon.

    Google Scholar 

  • Greenwald, B. S., Kramer-Ginsberg, E., Krishnan, K. R. R., Ashtari, M., Auerbach, C., & Patel, M. (1998). Neuroanatomic localization of magnetic resonance imaging signal hyperintensities in geriatric depression. Stroke, 29, 613–617.

    Google Scholar 

  • Greer, S., Morris, T., & Pettingale, K. W. (1979). Psychological response to breast cancer: Effect on outcome. The Lancet, 2, 785–787.

    Google Scholar 

  • Gronwall, D. (1977). Paced auditory serial-addition task: A measure of recovery from concussion. Perceptual Motor Skills, 44, 367–373.

    Google Scholar 

  • Irle, E., Peper, M., Wowra, B., & Kunze, S. (1994). Mood changes after surgery for tumors of the cerebral cortex. Archives of Neurology, 51, 164–174.

    Google Scholar 

  • Kinsella, G., Ong, B., Murtagh, D., Prior, M., & Sawyer, M. (1999). The role of the family for behavioral outcome in children and adolescents following traumatic brain injury. Journal of Consulting and Clinical Psychology, 67, 116–123.

    Google Scholar 

  • Krupp, L., LaRocca, N., Muir-Nash, J., & Steinberg, A. (1989). the fatigue severity scale. Archives of Neurology, 46, 1121–1123.

    Google Scholar 

  • Lezak, M. (1995). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Meyers, C. A., Weitzner, M. A., Valentine, A. D., & Levin, V. A. (1998). Methylphenidate therapy improves cognition, mood, and function of brain tumor patients. Journal of Clinical Oncology, 162522–2527.

    Google Scholar 

  • Newport, D. J., & Nemeroff, C.B. (1998). Assessment and treatment of depression in the cancer patient. Journal of Psychosomatic Research, 45, 215–237.

    Google Scholar 

  • Osteraker, A.-L., Kihlgren, M., & Melin, L. (1999). Long-term psychosocial consequences for families with children treated for brain-tumor and other malignancies [Abstract]. Journal of the International Neuropsychological Society, 5, 108.

    Google Scholar 

  • Peace, K. A., Orme, S. M., Sebastian, J. P., Thompson, A. R., Barnes, S., Ellis, A., et al. (1997). The effect of treatment variables on mood and social adjustment in adult patients with pituitary disease. Clinical Endocrinology, 46, 445–450.

    Google Scholar 

  • Pringle, A. M., Taylor, R., & Whittle, I. R. (1999). Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. British Journal of Neurosurgery, 13, 46–51.

    Google Scholar 

  • Redd, W. H., Silberfarb, P. M., Andersen, B. L., Andrykowski, M. A., Bovbjerg, D. H., Burish, T. G., et al. (1991). Physiologic and psychobehavioral research in oncology. Cancer, 67, 813–822.

    Google Scholar 

  • Ross, E. D., & Rush, A. J. (1981). Diagnosis and neuroanatomical correlates of depression in brain-damaged patients. Archives of General Psychiatry, 38, 1244–1354.

    Google Scholar 

  • Ross, L. K., & Long, C. J. (1990). Decision strategies in neuropsychology III: The relationship among lateralized dysfunction, etiology and depression. Archives of Clinical Neuropsychology, 5347–358.

    Google Scholar 

  • Sinyor, D., Jacques, P., Kaloupek, D. G., Becker, R., Goldenberg, M., & Coopersmith, H. (1986). Poststroke depression and lesion location. Brain, 109, 537–546.

    Google Scholar 

  • Smith, S. J., & Young, C.A. (2000). The role of affect on the perception of disability in multiple sclerosis. Clinical Rehabilitation, 14, 50–54.

    Google Scholar 

  • Spreen, O., & Strauss, E. (1991). A compendium of neuropsychological tests. New York: Oxford University Press.

    Google Scholar 

  • Starkstein, S. E., Robinson, R. G., & Price, T. R. (1989). Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. Brain, 110, 1045–1059.

    Google Scholar 

  • Stuber, M. L., Kazak, A. E., Meeske, K., Barakat, L., Guthrie, D., Garnier, H., et al. (1997). Predictors of posttraumatic stress symptoms in childhood cancer survivors. Pediatrics, 100, 958–964.

    Google Scholar 

  • Suzuki, R., Hirao, M., Miyo, T., Nagashima, G., Fujimoto, T., Ooshima, A., et al. (1998). Changes in QOL in patients with brain tumors measured by mood changes during and after treatment. No Shinkei Geka, 26, 795–801.

    Google Scholar 

  • Taphoorn, M. J. B., Schiphorst, A. K., Snoek, F. J., Lindeboom, J., Wolbers, J. G., Karim, A. B. M. F., et al. (1994). Cognitive functions and quality of life in patients with low grade gliomas: The impact of radiotherapy. Annals of Neurology, 36, 48–54.

    Google Scholar 

  • Webb, C. R., Wrigley, M., Yoels, W., & Fine, P. R. (1995). Explaining quality of life for persons with traumatic brain injuries two years after injury. Archives of Physical Medicine and Rehabilitation, 761113–1119.

    Google Scholar 

  • Wee, J. Y., Bagg, S. D., & Palepu, A. (1999). The Berg balance scale as a predictor of length of stay and discharge destination in an acute stroke rehabilitation setting. Archives of Physical Medicine and Rehabilitation, 8, 448–452.

    Google Scholar 

  • Weitzner, M. A., Meyers, C. A., & Byrne, K. (1996). Psychosocial functioning and quality of life in patients with primary brain tumors. Journal of Neurosurgery, 84, 29–34.

    Google Scholar 

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Correspondence to Carol L. Armstrong.

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Armstrong, C.L., Goldstein, B., Cohen, B. et al. Clinical Predictors of Depression in Patients with Low-Grade Brain Tumors: Consideration of a Neurologic Versus a Psychogenic Model. Journal of Clinical Psychology in Medical Settings 9, 97–107 (2002). https://doi.org/10.1023/A:1014987925718

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