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

PURPOSE: The primary objective of this study was to investigate the incidence of PTSD at 3 months 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.

METHODS: From 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 3 months after surgery. Followed-ups on survival status were made for 5 years.

RESULTS: A total of 219 subjects comprising 83 women and 136 men with a mean age of 41.5 years were included in this study. At 3 months 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).

CONCLUSIONS: The results showed that newly diagnosed LGG patients suffering from PTSD at 3 months 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.