Primary brain tumors are increasing in incidence in the United States and are devastating to patients and families. Because brain tumors and their treatment primarily affect the brain, psychiatric and psychosocial impact is rather unique. As opposed to systemic effects of other tumors and treatment, brain tumors have a direct effect on brain functioning and therefore affect cognition, mood, and personality. In fact, patients undergo dramatic changes in mood and cognition, showing specific impairments in functioning. These impairments get translated into disabilities when a patient's daily functioning is impaired and may become a handicap when viewed in the context of quality of life (QOL). This article describes observed neuropsychiatric syndromes, including the apathy syndrome, and neurocognitive effects of brain tumors and their treatment. The neuropsychiatric and neurocognitive issues are discussed in the context of QOL and psychosocial and cognitive interventions available for this patient population.