Evaluation and characterization of generalized anxiety and depression in patients with primary brain tumors.

To determine clinical and sociodemographic factors that are associated with major neuropsychiatric illnesses among brain tumor patients, we administered a modified version of the Brief Patient Health Questionnaire and a demographic data form to 363 adult neuro-oncology patients. Responses were analyzed to assess for associations between demographic variables, clinical variables, and symptoms consistent with diagnoses of generalized anxiety disorder and/or depression. Multivariate logistic regression analyses showed that female gender was associated with the presence of symptoms of anxiety, depression, and combined anxiety and depression. Lower WHO tumor grade classifications, lower education level, and a history of psychiatric illness also emerged as important predictors of symptoms consistent with anxiety and/or depression. Marital status and presence of past/current medical illness trended toward being significantly associated with depression alone. Patient use of psychiatric medication was not associated with any study variables. Results of the present study suggest several hypotheses to test with neuro-oncology patients in further longitudinal analyses, which would benefit from the inclusion of a wider range of neuropsychiatric symptoms in conjunction with neurocognitive and functional impairment variables.

Differential levels of stress in caregivers of brain tumor patients--observations from a pilot study.

OBJECTIVE: Caregivers of patients with brain tumors (BT) experience elevated levels of stress. Using pilot data, we sought to determine which caregivers are at risk for experiencing elevated levels of stress based on caregiver-demographic and patient-medical information. METHODS: Using a convenience sample of 60 caregivers, participants were asked to complete the Perceived Stress Scale and to provide demographic information. The Perceived Stress Scale is a 10-item scale designed to measure the degree to which situations in life are perceived as stressful. Demographic information was collected using self-reported measures. Medical data concerning tumor grade of patient were obtained from most recent medical note. Data for study were standardized using z-scores and analyzed using SPSS software. RESULTS: Seventy-two percent (n=43) of caregivers reported experiencing elevated levels of stress within the last 30 days. Thirty-five percent (n=21) of the sample scored at least one standard deviation above the mean. A statistical trend [F(1, 57)=3.12, p=0.08] exists between caregiver stress and tumor grade of patients for which they are providing care. CONCLUSIONS: Caregivers of patients with BT experience significant stress. Furthermore, this data provide an indication of the profound levels of stress these caregivers experience. Caregivers of patients with grade I/II tumors are at increased risk for experiencing stress. Younger caregiver age and higher levels of education were also found to correlate to higher levels of stress.

Stress and intervention preferences of patients with brain tumors.

BACKGROUND: Despite advances in diagnosis, treatment, and management of brain tumors, a brain tumor (BT) can significantly disrupt a person's life and create stress. To design effective stress reduction interventions, it is essential to have an understanding of the beliefs, past experiences, and preferences concerning stress reduction techniques and programs among patients with BTs. MATERIALS AND METHODS: Using a convenience sample, 60 adult patients with primary BTs completed the study questionnaire. Demographic information and patient preferences were collected using self-reported measures, medical information was collected via medical chart review, and stress was assessed using Perceived Stress Scale. RESULTS: Sixty-three percent of the population sampled experienced elevated levels of stress. Eighty-six percent wanted to learn about techniques to reduce stress and 78% believed stress reduction techniques can help reduce stress. However, only 56% indicated they would be able to participate in a stress reduction program twice a week and only 40% of the sample wanted to participate in the various stress reduction programs presented to them in this study. Furthermore, only 26% of the sample actually wanted to receive information about stress reduction programs and only 25% would participate in programs using the various modes presented. CONCLUSION: The results of this study clearly indicate that patients with BTs experience stress. Furthermore, the data is encouraging in regard to the patients' desire to learn about stress reduction techniques. However, the lack of interest in actually receiving information and the inability to envision themselves participating in programs present a major challenge.