TY - JOUR
T1 - Depression among adult patients with primary brain tumour
T2 - A cross-sectional study of risk factors in a low-middle-income country
AU - Pidani, Anum Sadruddin
AU - Siddiqui, Amna Rehana
AU - Azam, Iqbal
AU - Shamim, Muhammad Shahzad
AU - Jabbar, Adnan Abdul
AU - Khan, Shameel
N1 - Publisher Copyright:
© 2020 BMJ Publishing Group. All rights reserved.
PY - 2020/9/9
Y1 - 2020/9/9
N2 - Objective The prevalence of depression among patients with primary brain tumour ranges from 15% to 40% globally. Several individual and clinical factors contribute to the development of depression. However, their association with depression in Pakistani setting has not yet been assessed. Thus, we aim to study the factors associated with depression among adult patients with primary brain tumour at a tertiary care hospital in Karachi, Pakistan. Study design A prospective cross-sectional study. Setting This study was conducted at a tertiary care hospital of Karachi, Pakistan. Participants This study included 132 patients with confirmed diagnosis of primary brain tumour (initially diagnosed on MRI of the brain with contrast and later confirmed on histology of surgical specimen) in various stages of treatment. Primary outcome The primary outcome of this study was to assess depression and its associated factors among adult patients with primary brain tumour. Depression was assessed using a validated screening tool Patient Health Questionnaire-9 (PHQ-9). Scores of 10-27 on PHQ-9 were indicative of screen positive for depressive symptoms. A set of the structured pre-tested questions was used to evaluate patient-related, tumor-related and treatment-related factors. Results Fifty-one (39%, CI: 33.33-46.94) patients in our study screened positive for depressive symptoms on PHQ-9. There was a significant association between depressive symptoms and Karnofsky Performance Scores (KPS) (prevalence ratio: 3.25 and CI: 1.87-5.62) after controlling covariates. Propensity scores predicted a positive association between KPS (functional status) and unemployment, treatment stage, and tumour recurrence. Tumor-related and treatment-related factors including tumour grade, location, type and hemispheric lateralisation were found insignificant. Conclusion Depression is common in patients with primary brain tumour. Impaired functional status has a direct impact on depression in these patients. Incorporating the psychosocial domain earlier in the course of treatment needs to be considered for better neuro-oncology management of patients with primary brain tumour.
AB - Objective The prevalence of depression among patients with primary brain tumour ranges from 15% to 40% globally. Several individual and clinical factors contribute to the development of depression. However, their association with depression in Pakistani setting has not yet been assessed. Thus, we aim to study the factors associated with depression among adult patients with primary brain tumour at a tertiary care hospital in Karachi, Pakistan. Study design A prospective cross-sectional study. Setting This study was conducted at a tertiary care hospital of Karachi, Pakistan. Participants This study included 132 patients with confirmed diagnosis of primary brain tumour (initially diagnosed on MRI of the brain with contrast and later confirmed on histology of surgical specimen) in various stages of treatment. Primary outcome The primary outcome of this study was to assess depression and its associated factors among adult patients with primary brain tumour. Depression was assessed using a validated screening tool Patient Health Questionnaire-9 (PHQ-9). Scores of 10-27 on PHQ-9 were indicative of screen positive for depressive symptoms. A set of the structured pre-tested questions was used to evaluate patient-related, tumor-related and treatment-related factors. Results Fifty-one (39%, CI: 33.33-46.94) patients in our study screened positive for depressive symptoms on PHQ-9. There was a significant association between depressive symptoms and Karnofsky Performance Scores (KPS) (prevalence ratio: 3.25 and CI: 1.87-5.62) after controlling covariates. Propensity scores predicted a positive association between KPS (functional status) and unemployment, treatment stage, and tumour recurrence. Tumor-related and treatment-related factors including tumour grade, location, type and hemispheric lateralisation were found insignificant. Conclusion Depression is common in patients with primary brain tumour. Impaired functional status has a direct impact on depression in these patients. Incorporating the psychosocial domain earlier in the course of treatment needs to be considered for better neuro-oncology management of patients with primary brain tumour.
KW - adult
KW - brain tumor
KW - depression
KW - neurosurgery
KW - psychosocial factors
UR - http://www.scopus.com/inward/record.url?scp=85090818165&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2019-032748
DO - 10.1136/bmjopen-2019-032748
M3 - Article
C2 - 32912937
AN - SCOPUS:85090818165
SN - 2044-6055
VL - 10
JO - BMJ Open
JF - BMJ Open
IS - 9
M1 - e032748
ER -