Psychiatric aspects of brain tumors: A review

Table 1 Brain tumors and depressive symptoms[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Zivković et al[42], 2014	Depression, impairment in memory, motivation, concentration, insomnia, increased appetite, headaches	Parietal lobe	Epidermoid tumor	Subsequent neurological symptoms led to CT scan and diagnosis of the brain tumor
Assefa et al[43], 2012	Depression, anxiety, insomnia, headache, nausea, vomiting, unilateral abducens palsy	Parasellar and retrosellar areas of the petrous apex, temporal lobe	Meningioma	Neurologic deficit with psychiatric symptoms
Ozdilek et al[44], 2011	Depression, anxiety, headache	Left temporal lobe	Glial tumor	Persistent headache led to neurologic consult and CT, and diagnosis
Cheema et al[45], 2010	Depression, anhedonia, low energy, insomnia, suicidal ideations	Left frontal and temporal lobe	Glioblastoma multiforme	Duration of psychiatric symptoms of 10 yr make the association of glioblastoma questionable and possibly unrelated
Bunevicius et al[46], 2008	Depression, Parkinsonian symptoms	Right fronto-temporal	Meningioma	Subsequent neurological symptoms led to CT scan and diagnosis of the brain tumor
Bunevicius et al[46], 2008	Depression, psychosis	Left temporal lobe	Intra-cerebral cyst	Refractory symptoms
Habermeyer et al[47], 2008	Depression, delirium	Right frontal lobe	Glioblastoma multiforme	Psychiatric and neurological symptoms at initial presentation
Oreskovic et al[48], 2007	Depression, attention deficit hyperactivity disorder	Suprasellar and pineal regions	Germ cell tumor	Good prognosis with chemotherapy and radiation
Moise et al[49], 2006	Depression, headache, memory loss	Right thalamus	Glioblastoma multiforme	Partial improvement of symptoms with surgical treatment and antidepressants
Madhusoodanan et al[50], 2004	Recent depressive symptoms, anger and agitation	Left parietal	High grade glial neoplasm with sporadic cells	Resolution of depressive symptoms after surgery, chemo- and radiation therapy
Kohler et al[32], 2001	Depressive symptoms refractory to antidepressants, following surgical resection of left frontal neurocytoma	Left lateral ventricle, left frontal encephalomalacia	Neurocytoma	Good response to ECT
Ghaziuddin et al[31], 1999	Depressed mood, mania, suicidal ideation, irritability, guilt, grandiosity, early insomnia, olfactory hallucinations	Brainstem (ponto-mesencephalic)	Astrocytoma	Improvement with ECT
Kaplan[51], 1997	Progressive depression and anxiety	Right frontal and parietal	Unknown
Kugaya et al[52], 1996	Depressed mood, agitation, depersonalization, ideas of reference, suicidal ideation	Ependymal	Cyst	Partial removal of cyst led to complete resolution of symptoms
Griffith[53], 1995	Depression	Olfactory area	Esthesioneuroblastoma
Filley et al[8], 1995	Severe depression, extensive weight loss	Left frontal	Squamous cell carcinoma
Chipkevitch et al[54], 1993	Atypical anorexia nervosa, depression	Hypothalamus	Teratoma
Fulton et al[55], 1992	Reduced communication, depression, seizures, neurologic signs	Right frontal lobe	Astrocytoma	Poor response to steroid treatment
Goodman et al[56], 1992	Late-onset depressive symptoms, left-sided Horner’s syndrome	Several bi-frontal masses	Unknown
Ko et al[57], 1989	Depressive symptoms, emotional lability, amnesia for recent events	Multiple metastatic left fronto-parietal lesions	Origin in right lung	No surgical intervention
Tanaghow et al[58], 1989	Depressed mood, social withdrawal, personal neglect, apathy	Anterior corpus callosum	Unknown
Upadhyaya et al[59], 1988	Depression and delusions	Third ventricle	Colloid cyst
Greenberg et al[29], 1988	Treatment-resistant depression with delusions	Left fronto-parietal	Meningioma	Good response of psychiatric symptoms to ECT
Goldstein et al[30], 1988	Depression	Right frontal	Meningioma	Good response to ECT
Summerfield[60], 1987	Depression, psychosomatic symptoms	Cerebellum	Hemangioblastoma
Ghadirian et al[61], 1986	Depression and anxiety followed by visual hallucinations	Right temporal lobe	Meningioma
Uribe[62], 1986	Depressive symptoms with rage episodes, forgetfulness, disturbance in short-term memory and abstract thinking, later-onset headaches, disorientation, gait unsteadiness, hemiparesis	Left temporo-parietal	Glioblastoma multiforme
Dietch[63], 1984	Agoraphobia with panic attacks and major depression; later-onset right-sided weakness	Left fronto-parietal	Glioblastoma multiforme	Good response to imipramine, resolution of symptoms after surgery
Maurice-Williams et al[64], 1984	Depression, focal seizures	Frontal	Meningioma	Improvement of symptoms after tumor was removed
Fisher et al[65], 1983	Depression	Limbic system	CNS lymphoma
Barbizet et al[66], 1982	Rage attacks, Bulimia, uninhibited and brutal sexual behavior, periods of depression with suicide attempts	Fronto-temporal	Astrocytoma
Lahmeyer[67], 1982	Depression and urinary incontinence	Bilateral frontal	Meningioma	Good response to amphetamines
Littman et al[68], 1981	Depression, speech difficulties	Left temporal	Unknown
Khuan et al[69], 1979	Depression, poor work performance	Right thalamus	Unknown
Burkle et al[70], 1978	Depression, hypersomnia, anhedonia, low energy, poor concentration, memory lapses	Third ventricle with obstruction of lateral ventricles	Colloid cyst
Carlson[71], 1977	Severe depression; prior history of seizures	Frontal	Meningioma	Complete resolution of symptoms after surgery
Carlson[71], 1977	Severe depression	Right frontal	Grade IV astrocytoma	Resolution of symptoms after surgery
Scherrer et al[72], 1974	Depression followed by euphoria, then seizures	Frontal	Unknown
Blustein et al[73], 1972	Depression	Right temporal	Grade I astrocytoma
Avery[74], 1971	Depression, apathy	Right cribriform plate	Meningioma	Post-op manic episode before resolution of symptoms
Avery[74], 1971	Depression, apathy	Right cribriform plate	Meningioma	Improvement after surgery

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006. ECT: Emission computed tomography; CT: Computed tomography.

Table 2 Brain tumors and apathy[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Aydin et al[75], 2013	Loss of self-generated behavior, irritability, disinhibition, impulsivity	Midline subfrontal region	Meningioma	Psychiatric and neurologic symptoms with consequent diagnosis of brain tumor
Filley et al[8], 1995	Apathy, social-withdrawal, poor self-care	Bifrontal	Benign meningioma
Filley et al[8], 1995	Apathy, irritability, anomia, right hemiparesis	Left frontal lobe and genu of corpus callosum	Immunoblastic lymphoma
Filley et al[8], 1995	Apathy, amnesia, poor affect	Thalamic and fornical columns	Gonadotropic cell pituitary adenoma
Fulton et al[55], 1992	Loss of interest, poor concentration, withdrawal, lack of communication, neurologic signs	Left frontal lobe involving corpus callosum	Unknown
Tanaghow et al[58], 1989	Depressed mood, social withdrawal, personal neglect, apathy	Anterior corpus callosum	Unknown
Burkle et al[70], 1978	Depression, hypersomnia, anhedonia, low energy, poor concentration, memory lapses	Third ventricle with obstruction of lateral ventricles	Colloid cyst
Avery[74], 1971	Euphoria, drowsiness, and apathy	Tuberculum sellae	Meningioma	Some residual psychiatric disturbance following resection
Avery[74], 1971	Depression, apathy	Right cribriform plate	Meningioma	Post-op manic episode before resolution of symptoms
Avery[74], 1971	Depression, apathy	Right cribriform plate	Meningioma	Improvement after surgery
Avery[74], 1971	Apathy, change in work behavior	Cribriform plate	Meningioma	Improvement after surgery

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006.

Table 3 Brain tumors and manic symptoms[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Bhatia et al[76], 2013	Visual hallucinations, grandiosity, excessive talking, elated mood	Third ventricle	Neuroepithelial cyst	Psychiatric symptoms and diagnosis of brain tumor with no development of neurologic symptoms
Yetimalar et al[77], 2007	Personality change, psychomotor agitation, enhanced talkativeness and sex drive, decreased need for sleep	Pons	Cavernous angioma	Neurologic symptoms developed after the brain tumor was diagnosed
Ghaziuddin et al[31], 1999	Depressed mood, mania, suicidal ideation, irritability, guilt, grandiosity, early insomnia, olfactory hallucinations	Brainstem (ponto-mesencephalic)	Astrocytoma	Improvement with ECT
Mazure et al[78], 1999	Late-onset manic episode with psychotic features; no neurologic signs	Right temporal lobe	Glioblastoma multiforme	Good and rapid response of psychiatric symptoms to perphenazine
Filley et al[8], 1995	New-onset manic symptoms	Bitemporal	Glioblastoma multiforme
Mark et al[79], 1991	Treatment-resistant bipolar disorder	Acoustic nerve	Neurinoma	Symptoms resolved completely after tumor resection
Greenberg et al[29], 1988	Manic symptoms	Brainstem	Metastases, origin unknown
Jamieson et al[17], 1979	Mania	Right occipital, temporal and parietal lobes	Metastatic tumors- unknown primary source
Scherrer et al[72], 1974	Recurrent manic episodes	Frontal	Unknown
Avery[74], 1971	Mania, euphoria	Olfactory nerve	Meningioma	Some residual psychiatric disturbance following resection

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006. ECT: Emission computed tomography; CT: Computed tomography.

Table 4 Brain tumors and psychotic symptoms[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Krayem et al[27], 2014	Psychosis, auditory hallucinations, self-injurious behavior	Right temporal lobe	Astrocytoma	Psychosis developed either from tumor recurrence or right temporal brain tissue loss post-surgery
Kaloshi et al[80], 2013	Visual and auditory hallucinations, spasmodic laughter, minimal spontaneous speech	Cerebellum	Glioneuronal	Partial improvement of symptoms with surgery
Arasappa et al[81], 2013	Lethargy, anhedonia, persecutory delusions, and third person auditory hallucinations	Fourth ventricle	Choroid plexus papilloma	Improvement with surgery
Canuet et al[26], 2011	Schizophrenia-like psychosis	Right parietal lobe	Meningioma	Psychosis developed 6 yr after initial surgery with tumor recurrence. Gradual improvement with antipsychotics
Bunevicius et al[46], 2008	Schizophrenia	Left temporal lobe	Anaplastic oligodendroglioma	Improvement with surgery
Bunevicius et al[46], 2008	Depression, psychosis	Left temporal lobe	Intra-cerebral cyst	Refractory symptoms
Bunevicius et al[46], 2008	Schizophrenia	Left temporal lobe	Glioblastoma multiforme
Parisis et al[82], 2003	Peduncular hallucinosis (complex visual hallucinations), sleep impairment	Cerebellar metastases	Metastases	Mechanism thought to be extrinsic compression of posterior midbrain-pons by mass edema
Rueda-Lara et al[83], 2003	Delusions, hallucinations	Pituitary	Hormone producing adenoma
Maiuri et al[84], 2002	Hallucinations	Posterior thalamus	Glioblastoma multiforme	Partial improvement of symptoms with surgical treatment and antidepressants
Miyazawa et al[85], 2001	Headaches and psychotic symptoms	Pineal	Pineal meningioma	Improvement with surgery
Miyazawa et al[85], 2001	Headaches and psychotic symptoms	Pituitary	Unknown	Improvement with steroid/hormone treatment
Craven[86], 2001	Acute psychotic episode	Pineal	Germinoma
Vardar et al[87], 2000	Psychotic symptoms and cognitive deterioration	Right temporo-parietal	Arachnoid cyst
Mordecai et al[88], 2000	Psychotic and obsessive-compulsive symptoms, left-sided weakness, diabetes insipidus, decline in academic functioning	Bilateral basal ganglia	Germinoma
Werring et al[89], 1999	Visual hallucinations, palinopsia, posterior headache	Occipital	Tuberculoma
Carson et al[90], 1997	Pediatric psychosis - hallucinations, aggression, violence	Third ventricle	Choroid plexus papilloma	Symptoms improved after surgical removal
Ball[91], 1996	Persecutory delusions, auditory and visual hallucinations, fluctuating levels of consciousness followed by grand-mal seizures	Cerebellopontine angle	Meningioma
Filley et al[8], 1995	Psychotic symptoms (perceptual disturbances)	Temporal	Low-grade oligoastrocytoma
Okada et al[92], 1992	Positive and negative psychotic symptoms	Left basal ganglia	Unknown	Positive symptoms resolved after surgical resection, but negative symptoms persisted
Trabert et al[93], 1990	Symptoms of anorexia followed by seizures and psychosis	Temporo-basal	Angioma
Nagaratnam et al[94], 1990	Paranoid delusions	Left frontal lobe	Venous angioma
Ko et al[57], 1989	Paranoid ideation, irritability, short-term memory difficulties	Left parieto-occipital metastatic lesion	Origin in right kidney	No surgical intervention due to advanced stage
Dyck[95], 1985	Auditory hallucinations	Sylvian fissure	Lipoma
Binder[96], 1983	Sudden behavioral changes followed by paranoid delusions; no focal neurologic signs	Right lateral ventricle	Meningioma	Complete resolution of symptoms after surgical intervention
Binder[96], 1983	New-onset rage attacks on background of chronic schizophrenia	Bilateral occipital	Meningioma	Resolution of rage attacks after surgical removal
Dunn et al[97], 1983	Peduncular hallucinations	Midbrain compression	Cystic craniopharyngioma	Prompt resolution after drainage of cyst
Soulairac et al[98], 1979	Peduncular hallucinosis	Right temporal	Astrocytoma
Buchanan et al[99], 1975	Pressured speech, hypomania, persecutory delusions	Lateral ventricle	Meningioma
Blustein et al[73], 1972	Thought disorder, auditory hallucinations	Left parieto-occipital	Porencephalic cyst

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006.

Table 5 Brain tumors and personality changes[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Lajara-Nanson[100], 2000	Personality changes and hypersexual behavior	Ventricular	Ventricular cyst	Improvement with surgery
Paul et al[101], 2000	Personality changes, memory impairment, poor concentration	Extramedullary with infiltration of the cerebral dura	Plasmacytoma
Fahy et al[102], 1995	Frontal lobe symptoms in absence of neurological signs	Frontal	Meningioma
Jones[103], 1993	Personality changes, aggressive behavior, and emotional lability	Ventricular	Ventricular cysts	Improvement with surgery
Fulton et al[55], 1992	Personality changes, walking difficulties, incontinence, neurologic signs	Frontal lobe	Multiple metastases	Poor response to steroid treatment
Fulton et al[55], 1992	Bizarre, disinhibited behavior, neurologic signs	Multiple left orbito-frontal and right thalamus	Astrocytoma	Poor response to steroid treatment
Fulton et al[55], 1992	Withdrawn, inappropriate behavior, neurologic signs	Bifrontal	Unknown	Poor response to steroid treatment
Lobosky[104], 1984	Personality changes and emotional lability	Ventricular	Ventricular cysts	Improvement with surgery
Barbizet et al[66], 1982	Rage attacks, Bulimia, uninhibited and brutal sexual behavior, periods of depression with suicide attempts	Fronto-temporal	Astrocytoma

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006.

Table 6 Brain tumors and eating disorders[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Vad Winkler et al[105], 2009	Eating disorder	Pituitary gland	Craniopharyngioma	Improvement with surgery
Vad Winkler et al[105], 2009	Eating disorder	Third ventricle	Craniopharyngioma	Developed pituitary deficiency after surgery
Houy et al[106], 2007	Anorexia nervosa	Frontal side of the right sylvian valley	Cavernous hemangioma	Improvement with surgery
Lin et al[107], 2003	Anorexia nervosa	Hypothalamic region, third ventricle, pineal region, lateral ventricle, corpus callosum	Unknown
Wolańczyk et al[108], 1997	Anorexia nervosa, delusions, catatonia	Right parietal lobe	Arachnoid cyst
Chipkevitch et al[54], 1993	Atypical anorexia nervosa, depressive symptoms	Hypothalamus	Teratoma
Berek et al[109], 1991	Anorexia nervosa	Third ventricle	Teratoma
Trabert et al[93], 1990	Symptoms of anorexia followed by seizures and psychosis	Temporo-basal	Angioma
Climo[110], 1982	Anorexia nervosa	Hypothalamus	Craniopharyngioma
Weller et al[111], 1982	Anorexia nervosa	Pineal gland	Pinealoma
Goldney[112], 1978	Anorexia nervosa	Hypothalamus	Craniopharyngioma
Swann[113], 1977	Anorexia nervosa	Hypothalamus	Pinealoma
White et al[114], 1977	Anorexia nervosa	Hypothalamus	Glioma
Heron et al[115], 1976	Anorexia nervosa	Hypothalamus	Unknown
Daly et al[116], 1973	Anorexia nervosa	Hypothalamus	Ectopic pinealoma

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006.

Table 7 Brain tumors and miscellaneous symptoms[41]

Ref.	Psychiatric symptoms	Tumor location	Tumor type	Remarks
Feng et al[20], 2013	Anomic aphasia	Left temporal lobe	Glioblastoma multiforme	No resolution of aphasia after surgical treatment
Hoffmann et al[117], 2012	Crying, spitting, biting self and others, mutism, withdrawal, sleepiness, anergia, bipolar affective disorder	Pituitary gland	Craniopharyngioma	No resolution of symptoms after surgery
Wong et al[118], 2012	Attacks of sensory overload and unusual familiarity	Left temporal lobe	Epidermoid tumor
Rosenzweig et al[119], 2010	Epilepsy, paroxysmal ictal phonemes	Left superior temporal gyrus	Angiocentric glioma grade I	Resolution of symptoms after surgery
Tsutsumi et al[21], 2008	Abnormal laughter, left-hemiparesis	Right frontal lobe	Glioblastoma multiforme	Resolution of psychiatric symptoms after surgical treatment
Sokolski et al[120], 2003	Breakthrough manic symptoms with mild nausea and dizzy spells, daily derealisation episodes with olfactory auras	Right medial temporal, displacing right ventricle and right hippocampus	Grade IV invasive astrocytoma	Improvement of psychiatric symptoms with surgical resection
Burns et al[121], 2003	New-onset pedophilia	Right orbito-frontal	Unknown
Daigneault et al[122], 1999	Aggression, precocious puberty and worsening seizures	Hypothalamic	Hamartoma
Konovalov et al[123], 1998	Korsakoff’s syndrome	Third ventricle	Colloid cyst	Complete resolution after surgical removal
Caplan et al[124], 1992	Intractable seizures followed by coprolalia, compulsive behaviors, aphasia	Left anterior temporal	Ganglionoma	Symptoms subsided after surgical resection
Ko et al[57], 1989	Expressive aphasia, short-term memory difficulties, no focal neurologic signs	Multiple metastatic left fronto-parietal lesions	Origin in right lung
Ko et al[57], 1989	Deteriorating memory and disorientation to time and place, behavioral changes, visual agnosia, aphasia, self-neglect	Left parietal extending to temporal lobe with midline shift	Unknown-surgery refused- no autopsy report given
Ribeiro et al[125], 1989	Bonnet syndrome, blindness	Posterior parasagittal	Meningioma
Durst et al[126], 1988	Koro	Corpus callosum	Lipoma or dermoid tumor
Binder[96], 1983	Behavioral changes, confusion with neurological signs developing after 24 h	Left thalamic	Glioblastoma multiforme
de Bures et al[127], 1982	Aggressive behavior, cognitive impairment on background of chronic alcohol abuse and head injuries	Left temporal	Astrocytoma

Adapted from Trends in Brain Cancer Research. New York: Nova Science Publishers Inc., 2006.