The Association of Pre-Operative Anxiety and Depression with Quality of Life in Glioma Patients

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2018-08

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Abstract

Background: Patient quality of life has become an important endpoint of clinical research in the brain tumor population. Previous studies have identified depression symptomatology as an important predictor of both general and domain-specific quality of life (i.e., physical, social, or role functioning). Despite the high rate of co-occurrence of depression and anxiety symptoms in medical populations, few studies have examined the association between anxiety, depression and quality of life in the brain tumor population. Purpose: The present study examined the combined and unique associations of anxiety and depression to both general and domain-specific quality of life in the pre-operative glioma population, as well as the moderating effect of anxiety on the relationship between depression and quality of life. Methods: Archival data from the neuropsychology clinic at a comprehensive cancer center were used to identify 99 individuals who fit study criteria. Seven hierarchical regression models were conducted to predict overall quality of life as well as domain-specific quality of life (physical, role, cognitive, emotional, social, and brain-specific functioning). Univariate analyses were conducted to determine which sociodemographic (age, sex, marital status, education), clinical (tumor location, lateralization, WHO tumor grade, anti-epileptic drug use, corticosteroid use, neurocognitive functioning status), and mental health (anxiety and depression symptoms) variables were to be included in multivariate analyses. Results: Anxiety did not moderate the relationship between depression and overall or domain-specific quality of life; however, depression and anxiety both contributed unique variance in predicting overall quality of life, as well as domain-specific quality of life in the realms of emotional, cognitive, social, and brain-specific functioning. Anxiety contributed unique variance to physical quality of life while depression did not, and depression contributed unique variance to role quality of life, while anxiety did not. Conclusion: Study results did not support a moderation effect of anxiety on the relationship between depression symptoms and quality of life in the glioma population. However, anxiety and depression appear to make unique and distinct contributions in the various domains of quality of life, which support the notion that anxiety and depression are separate constructs.

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Keywords

Glioma, Brain tumor, Quality of life, Anxiety, Depression

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