Study Recommends Brain Cancer Patients Be Screened for Depression


Key Points

  • Greater depressive symptom severity is associated with shorter overall survival in patients with brain tumors.
  • The authors proposed implementing reliable depression screening algorithms in routine neuro-oncology settings that improve recognition of depression, and, ultimately, improve patient outcomes

Depression in brain cancer patients is a common but often overlooked condition, and oncologists should regularly screen tumor patients for depression, according to an article by Pranckeviciene and Bunevicius in CNS Oncology. The authors, both of the Lithuanian University of Health Sciences, also propose that more studies be completed to explore the efficacy of antidepression treatments, as well as the value of depression biomarkers for future brain tumor research.

“Psychological distress is an important complication in patients with brain tumors but often remains undiagnosed and untreated,” said Adomas Bunevicius MD, PhD. “Methodologically rigorous studies aiming to identify the most optimal depression screening tools for patients with brain tumor are lacking. As a consequence, to date there are no evidence-based depression diagnostic algorithms.”

New Screening Standards

The authors proposed that implementation of reliable depression screening algorithms in routine neuro-oncology setting could improve recognition of depression, and, ultimately, improve patient outcomes. They reviewed available screening tools and recommend the use of The Hospital Anxiety and Depression Scale’s two derivatives, the Depression Subscale and the Patient Health Questionnaire.

The authors recommend that patients who screen positive for depression be referred for detailed psychiatric assessment prior to initiating antidepressive treatment, and that further methodologically rigorous studies investigating psychometric properties of depression scales are urgently needed. Studies evaluating the efficacy of antidepressive treatments and the clinical value of depression biomarkers are also important avenues for future research endeavors in brain tumor patients.

“We believe that studies aiming to improve identification and management of psychological distress should be considered a priority in the field of neuro-oncology,” said Dr. Bunevicius. “Such knowledge could significantly improve quality of life and clinical outcomes for patients suffering from these devastating disorders.”

Improving Survival and Quality-of-Life Outcomes

The reasons cited for a deeper focus on depression in brain tumor patients are twofold. First, patient-centered outcomes, including symptoms of psychological distress, are increasingly being used as secondary outcomes measured in clinical trials. Therefore, accurately identifying brain tumor patients suffering from psychological distress is becoming increasingly important in both clinical practice and in research studies.

In addition, and more important, depression carries serious health risks for those with brain tumors. Studies have associated greater depressive symptom severity with shorter overall survival of brain tumor patients, and depressive symptoms have been linked to numerous health-related aspects of quality of life. Furthermore, depression predicts cognitive impairment and puts survivors at increased risk for suicide ideation. Therefore, depression should be actively sought and managed in patients with established diagnosis of a brain tumor.

Dr. Bunevicius is the corresponding author for this article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.