Frequency, Clinical Associations, and Longitudinal Course of Major Depressive Disorder in Adults With Cerebral Glioma
- 10 November 2011
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 29 (32), 4307-4312
- https://doi.org/10.1200/jco.2011.34.8466
Abstract
Purpose There is a need for high-quality evidence regarding the frequency, independent clinical associations, and longitudinal course of depression in patients with cerebral glioma. Patients and Methods This was a twin-center, prospective, observational cohort study with 6-month follow-up. Consenting adults with a new diagnosis of cerebral glioma received the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to diagnose major depressive disorder (MDD). Interviews occurred shortly after the start of radiotherapy (T1), with follow-up interviews 3 months later (T2) and 6 months later (T3). Independent associations between MDD and clinical variables were analyzed using logistic regression. Results One hundred fifty-five patients participated. The frequency of MDD was 13.5% ± 5.4% at T1 (n = 155); 14.8% ± 6.7% at T2 (n = 108); and 6.8% ± 5.3% at T3 (n = 88). Overall, 32 individuals were diagnosed with MDD during the study period (20.6% ± 6.4%). Inter-rater diagnostic agreement for MDD was good (κ = 0.81; 95% CI, 0.60 to 1.00). Independent predictors of MDD were functional impairment (odds ratio, 3.9; 95% CI, 1.5 to 10.8) and a previous history of depression (odds ratio, 2.7; 95% CI, 0.99 to 7.3). MDD persisted for at least 3 months in half of the patients with adequate follow-up, but many depressed patients also dropped out of the study as a result of clinical deterioration. Conclusion In this longitudinal study, one in five patients with glioma developed clinical depression in the 6 months after starting radiotherapy. Patients with functional impairment or previous depression were at higher risk. MDD often persisted for at least 3 months. Clinicians should seek and treat depression in adults with glioma.This publication has 18 references indexed in Scilit:
- Depression in Cerebral Glioma Patients: A Systematic Review of Observational StudiesJNCI Journal of the National Cancer Institute, 2010
- Psychiatric co-morbidity in 75 patients undergoing epilepsy surgery: Lack of correlation with pathological findingsEpilepsy Research, 2008
- State and trait anxiety and depression in patients with primary brain tumors before and after surgery: 1-year longitudinal studyJournal of Neurosurgery, 2008
- Is Mrs S Depressed? Diagnosing Depression in the Cancer PatientJournal of Clinical Oncology, 2007
- The Addenbrooke's Cognitive Examination Revised (ACE‐R): a brief cognitive test battery for dementia screeningInternational Journal of Geriatric Psychiatry, 2006
- Radiotherapy plus Concomitant and Adjuvant Temozolomide for GlioblastomaThe New England Journal of Medicine, 2005
- Depression in Patients with High-grade Glioma: Results of the Glioma Outcomes ProjectNeurosurgery, 2004
- Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needsBritish Journal of Cancer, 2004
- Predicting major depression in brain tumor patientsPsycho‐Oncology, 2002
- A prospective study of the early postsurgical psychiatric associations of epilepsy surgeryJournal of Neurology, Neurosurgery & Psychiatry, 1998