GC-21PSYCHIATRIC SYMPTOMS IN CHILDREN WITH SUPRASELLAR TUMORS

Abstract

Background: Neuronal networks that encompass cortical midline and subcortical limbic structures have long been implicated in affective disorders. In addition, our prior unpublished data has found increased rates of psychosis in children with germ cell tumors compared to medulloblastoma. We hypothesize childrenwith suprasellartumors are atrisk foraffectivedisorders and will have similar rates of mood and anxiety, while germ cell tumors will have increased rates of psychosis compared to other suprasellar tumors. Methods: Patients were identified via the Lucile Packard Children's Hospital Pediatric Brain Tumor Database and included if they were aged birth to 30 years at diagnosis, diagnosed between 1/1/1997-6/1/2013. Psychiatric symptoms were considered present when documented by clinical psychologist or pediatric psychiatrist, or documented administration of psychiatric medication. Descriptive statistics were performed using Anova and Fisher's exact test where appropriate. Results: Craniopharyngioma, germ cell tumor, and low-grade glioma cases were identified in 27, 25, and 38 patients respectively. No difference was found in the incidence of mood or anxiety disorders (p = 0.6636). We did find a significant difference in incidence of psychosis (p = 0.0361) with rates of 4%, 12%, and 0%, respectively. Conclusions: Psychiatric sequelae of pediatric brain tumors and their therapyare under-recognized and poorly understood. Similar rates of affective disorders for pediatric patients with suprasellar tumors suggest symptoms relate to their location and subsequent disruption of surrounding neural networks. Further work needs to elucidate why germ cell tumors have increased incidence of psychosis.