gms | German Medical Science

Objective: Malignant intracranial tumors rank among those neoplastic lesions that result in the highest emotional burden for affected patients. These tumors are often associated with high rates of anxiety and/or depression and reduced health related quality of life. Until now patients only receive psychosocial assistance at recognized tumor centers, but there is still no standardized psychooncological assessment of these patients. Therefore, we analysed the impact of the diagnosis on the psychooncological treatment.

Method: Patients, who were electively admitted for surgery of intracranial lesions were perioperatively screened for their psychooncological treatment demand independent of the diagnosis. Two different self-assessment instruments were used (Distress Thermometer (DT) and Hospital Anxiety and Depression Scale (HADS)), as well as one external assessment questionnaire (Psychooncological base documentation (PO-Bado)).

Results: 514 patients could be screened since October 2013. Depending on the diagnosis, patients were divided into: Group A (n=333) patients with malignant cerebral lesions (anaplastic glial tumors (n=261), brain metastasis (n=72)); Group B (n=181)) with benign intracranial lesions (vascular diagnoses (n=23), meningeoma (n=92), pituitary tumors (n=34), other diagnosis (n=32)).

Screening was positive in 179 patients (53.7%) of Group A and 74 patients (40.9%) of Group B. Regarding the different self-assessment screening tools, the DT was positive in 38.7% (n=129) of Group A (sensitivity 72%; specificity of 72%) and in 34.2% (n=62) of Group B (sensitivity of 65%; specificity 67%).

HADS was positive in 18.9% (n=63) of Group A (sensitivity 56%; specificity 85%) and in 9.9% (n=18) of Group B (sensitivity 41%; specificity 92%).

Regarding the external assessment questionnaire PO-Bado 25.5% (n=85) of Group A (sensitivity 60%; specificity 81%) were tested positive compared to 19.9% (n=36) of Group B (sensitivitiy 56%; specificity 78%).

Conclusions: Our results implicate a higher emotional distress caused solely by the neurosurgical operation when compared to other tumors. However, psychooncological treatment seems to be more important for patients with malignant brain tumors than for to patients with benign lesions. DT seems to be more sensitive compared to the HADS or PO-Bado.