gms | German Medical Science

Objective: Cerebral gliomas are associated with high rates of anxiety, depression and health-related impairment of quality of life. But until now there is no standardized psychooncological assessment that enquires the need for psychooncological treatment (PT) for glioma patients. Likewise, less is known about disease-specific impact factors, best screening time point or impact of psychooncological treatment. Here, we report our experience of the last 5 years regarding screening of high- and low-grade glioma patients, specific sociodemographic factors and different test items.

Methods: Patients with histopathological diagnosed glioma as well as patients with low grade glioma-suspicious lesions on MRI were screened at different time-points (perioperatively and postoperatively every 3 month) using three different self-assessment instruments (Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), EORTC-QLQ-C30 B20) as well as one external assessment questionnaire (psychooncological base documentation, PoBADO).

Results: Since October 2013, 888 patients (150 low-grade glioma (LGG) and 376 high-grade glioma, (HGG) patients, 136 other malignant cerebral tumors, 226 benign tumors) were screened. Regarding screening instruments, the DT had a comparable specificity and sensitivity to HADS. The more time consuming external assessment did not show any additional impact. Comparing DT (>5, emotional problems³ 3) and PoBADO to HADS, sensitivity of DT was better than PoBado (90.2% vs. 71.2%) while same specificity (77.7% vs 78.6%). There was no significant difference in conspicuous findings between diagnosis (benign/malign) p=0.425. Patients with histologically verified LGG tend to have a higher need for PT (36/105 patients (34.2%) than patients with LGG suspicious findings in MRI and active surveillance (10/45 patients (22.2%). As predictive factors for the need of PT, a positive psychological anamnesis (p=0.001), as well as recurrent tumors (p=0.003) could be identified.

Conclusion: Our 5-years experience underlines the importance of distress screening in glioma patients. In 27% of all patients a need of PT was observed. DT und HADS were comparable to each other. There seems to be no need for time consuming external questionnaires. Emotional distress was highest before surgery. Previous need of PT and tumor recurrence were identified as predictive factors for increased distress.