Clinical Correlates of Anxiety and Depression After Diagnosis of a Pediatric Brain Tumor

Abstract

Background: The prevalence and clinical correlates of symptoms of anxiety and depression in pediatric patients with brain tumors are not well described. We aimed to identify clinical characteristics that are correlated with elevated symptoms of anxiety and depression following initial diagnosis. Procedure: Pediatric patients diagnosed with a brain tumor at Texas Children's Hospital from 2012 to 2019 were enrolled. Using the parent-proxy report form of the BASC-2, patients were assessed for symptoms of anxiety and depression within 6 months of diagnosis. Correspondence analysis was applied to determine the correlation values (r) for anxiety and depression; r ≥ 0.71 was considered statistically significant as it explained at least 50% of the shared variance. Results: All patients (n = 149, mean age = 9 years [range 3–18], 56% male) underwent a tumor-directed surgery or biopsy. Overall, 24% (n = 35) of patients had elevated symptoms of anxiety, and 15% (n = 22) had elevated symptoms of depression. There was a strong correlation between elevated anxiety symptoms and surgical resection alone (r = 0.96), surgery plus chemotherapy (r = 0.86), and infratentorial tumors (r = 1.00). Elevated depression symptoms correlated with a diagnosis of low-grade glioma (r = 1.00), infratentorial tumors (r = 0.76), and low global intellectual functioning (r = 0.81). Conclusions: Treatment type, tumor histology, tumor location, and global intellectual functioning are significantly associated with anxiety and depression symptoms in children with brain tumors close to the time of diagnosis. These findings may inform the provision of screening and supportive services to these high-risk groups.