gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Diagnosis of a brain tumor represents psychological disorder of patients – an analysis in the first postoperative days with the Distress Thermometer and the Hornheide Screening Instrument

Meeting Abstract

  • M. Renovanz - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital
  • M. Haug - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital
  • C. Würtenberger - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital
  • M.N. Nadji-Ohl - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital
  • G. Strittmatter - Abteilung für Psychosoziale Onkologie, Fachklinik Hornheide, Münster
  • N. Hopf - Klinik für Neurochirurgie, Klinikum Stuttgart, Katharinenhospital

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocSA.07.10

DOI: 10.3205/12dgnc350, URN: urn:nbn:de:0183-12dgnc3506

Published: June 4, 2012

© 2012 Renovanz et al.
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Outline

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Objective: In patients the diagnosis of a brain tumor and a planned operation can cause a large amount of psychosocial distress, which can have a variety of negative consequences on patients' physical and mental well-being. The detection of psychosocial distress in daily clinical routine is difficult and referral to mental health professionals is in many cases insufficient. The aim of the study was to determine the distress of patients in this special early postoperative situation and to investigate the practicability of the Hornheide Screening Instrument (HSI) and Distress Thermometer (DT), which has been validated for patients with braintumors.

Methods: 94 patients, 28 male, 65 female, harbored tumor suspicion lesions: 42 in the right, 48 in the left hemisphere. They were postoperatively evaluated by the Distress Thermometer. Hornheide Screening Instrument which comprises 7 interview questions to identify patients at psychosocial risk after the anamnestic interview. Furthermore, as second screening instrument DT was used which is a visual analogue scale evaluating psychological distress. In addition location of the tumor, Karnofsky performance score and tumor entity were analyzed.

Results: After surgery 20 patients (21,2%) had pathologic results in the HSI and 40 patients (42%) were distressed (DT Score >6), the mean score was 4,9. The two screening instruments showed consistent results in 60 patients. Patients with metastases had the highest rate of pathological results after surgery (5 patients, 45%), patients with gliomas had a higher rate than patients with meningiomas (7 patients, 15% vs. 3 patients, 10%). 9 patients with distress symptoms in the screening with HSI were presented to mental health professionals, 4 were recruited to a follow up study analyzing quality of life and mental health after tumor surgery, 3 had already their own psychologist, 1 patient denied treatment and 3 patients had no intervention.

Conclusions: The Hornheide Screening instrument is practicable instrument to identify patients with brain tumors at psychosocial risk postoperatively in the clinical routine. The study shows that diagnosis of a brain tumor represents distress in the first period for almost the half of the patients and 20% need treatment of a mental health professional. However, further evaluation concerning long-term development of the mental health of the patients and a validation of the HSI in patients with braintumors is needed.