Postoperative Depression May Go Unrecognized and Untreated in Brain Tumor Patients

Depression is the most common postoperative complication seen in patients who have undergone surgery for brain tumors, but it is seldom recognized or treated, according to preliminary findings of a study presented at the annual meeting of the American Association of Neurological Surgeons.

The study involved data on 285 patients enrolled at 54 clinical sites in the United States and Canada who had undergone surgery for high-grade glioma. Researchers found that while 34% of patients reported experiencing at least 2 weeks of postoperative depression during the previous year, physicians had diagnosed postoperative depression in only 14%, and only 5% of those diagnosed (15 patients) had received antidepressant medication.

Although a planned 2-year follow-up is still ongoing, “These preliminary findings demonstrate the magnitude of the problem of postoperative depression in glioma patients,” said Frederick A. Anderson, Jr.,PhD, director of the Center for Outcomes Research and coauthor of the study with N. Scott Litofsky, MD, FACS, associate professor of surgery in the Division of Neurosurgery, both at the University of Massachusetts Medical School in Worcester. “These observations should help physicians become more aware of the symptoms of depression in their patients.”

Project to Track Trends in Glioma Care

The study is the first research to emerge from the Glioma Outcomes (GO) Project. The goal of this North American database is to provide data useful for the evaluation and improvement of care of patients with glioma.

Patient accrual in the GO Project began in November 1997, and the database is being coordinated by the Center for Outcomes Research at the University of Massachusetts Medical School. The project is being underwritten by an educational grant from Rhone-Poulenc Rorer Pharmaceuticals Inc.

The GO Project is designed to track trends in patient characteristics and glioma care, including natural history, risk factors, diagnostic approach, resource utilization, and treatment methods. Participating neurosurgeons report data on their glioma patients at surgery and at 3-month intervals for up to 2 years. Patients, who provide written informed consent, complete questionnaires regarding their functional status and satisfaction with care at similar intervals. The central data coordinating center summarizes and analyzes the data and sends regular reports to neurosurgeons.

“Quality of life issues for glioma patients are rarely addressed,” said Dr. Anderson. “The Glioma Outcomes Project will provide physicians with benchmark data that will allow them to compare their individual practice patterns and outcomes with the experience of their peers in caring for comparable patients, and identify opportunities to improve quality of care for those patients.”