Abstract
Brain tumors are associated with a dismal prognosis, and the diagnosis of intracranial tumors can evoke significant psychological disturbance. However, the evolution of patients' emotional status over the clinical course of brain tumors is less well understood. This study aims to document the prevalence of anxiety and depression in brain tumor patients and examine the risk factors associated with postoperative emotional derangement. Their psychological conditions were assessed using the Hospital Anxiety and Depression Scale (HADS) at various preoperative and postoperative time points. A total of 159 patients who underwent surgery and underwent HADS assessment between May 2018 and November 2020 were included in the analysis, with 112 gliomas and 47 metastatic brain tumors. After surgery, the incidence of anxiety increased for the glioma group (from 3.8–11.2%) and the metastatic brain tumor group (from 8.9–11.1%). Similarly, the prevalence of depression increased among glioma patients (from 8.6–18.4%) and metastatic tumor patients (from 20.0–31.1%). In either the glioma or metastatic group, tumors involving the frontal lobe were associated with a significant increase in postoperative HADS depression score. Univariate analysis among glioma patients indicated that males exhibited a reduced risk of postoperative exacerbation of anxiety, while right-sided tumors were associated with a decreased risk of postoperative worsening of depression. In the metastatic group, a BMI > 24 was a risk factor for postoperative anxiety exacerbation, whereas a temporal-lobe lesion was a protective factor in HADS depression worsening after surgery. The findings from the present research illustrate patient characteristics with a higher risk of psychological disturbance exacerbation postoperatively, aiding in early prevention and improving the quality of life among patients with intracranial tumors.