Post-traumatic stress disorders in patients with low-grade glioma and its association with survival

PurposeThe primary objective of this study was to investigate the incidence of PTSD at 3months postoperatively in patients who were newly diagnosed with LGGs, and its association with 5-year survival. Moreover, QoL and other psychiatric disorders like depression and anxiety were also evaluated.MethodsFrom February 2011 to April 2013, patients who underwent low-grade glioma surgery at our hospital and come back for reexamination at 3-month follow-up were considered for this study. Interviews, HADS-A, HADS-D, and SF-36 scales were used for evaluating PTSD, anxiety, depression, and quality of life. Participants were asked to complete these assessments at 3months after surgery. Followed-ups on survival status were made for 5years.ResultsA total of 219 subjects comprising 83 women and 136 men with a mean age of 41.5years were included in this study. At 3months after surgery, 35 (16%) patients were diagnosed with PTSD. Younger age (OR=2.23, [95% CI 1.02-4.84], P=0.04) and frontal lobe involvement of tumor (OR=2.57, [95% CI 1.06-6.23], P=0.04) predicted PTSD. Patients with PTSD had higher anxiety and depression level, and had worse QoL in all eight dimensions of SF-36. Kaplan-Meier analyses demonstrated that diagnosis of PTSD was associated with shorter overall survival in LGG patients (Log-rank=7.45, P=0.01). After adjusting for other variables, PTSD remained associated with elevated 5-year overall mortality risk of LGG patients (HR=2.98 [95% CI 1.10-8.05], P=0.03).ConclusionsThe results showed that newly diagnosed LGG patients suffering from PTSD at 3months after surgery had lower rates of 5-year survival. In clinical practice, psychological evaluation is suggested for LGG patients and proper psychotherapy should be considered for those with PTSD.