title: Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma.
abstract: OBJECTIVE
  There is a need for high-quality evidence regarding the frequency, independent clinical associations, and longitudinal course of depression in patients with cerebral glioma.
  
  
  METHODS
  This was a twin-center, prospective, observational cohort study with 6-month follow-up. Consenting adults with a new diagnosis of cerebral glioma received the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to diagnose major depressive disorder (MDD). Interviews occurred shortly after the start of radiotherapy (T1), with follow-up interviews 3 months later (T2) and 6 months later (T3). Independent associations between MDD and clinical variables were analyzed using logistic regression.
  
  
  RESULTS
  One hundred fifty-five patients participated. The frequency of MDD was 13.5% ± 5.4% at T1 (n = 155); 14.8% ± 6.7% at T2 (n = 108); and 6.8% ± 5.3% at T3 (n = 88). Overall, 32 individuals were diagnosed with MDD during the study period (20.6% ± 6.4%). Inter-rater diagnostic agreement for MDD was good (κ = 0.81; 95% CI, 0.60 to 1.00). Independent predictors of MDD were functional impairment (odds ratio, 3.9; 95% CI, 1.5 to 10.8) and a previous history of depression (odds ratio, 2.7; 95% CI, 0.99 to 7.3). MDD persisted for at least 3 months in half of the patients with adequate follow-up, but many depressed patients also dropped out of the study as a result of clinical deterioration.
  
  
  CONCLUSIONS
  In this longitudinal study, one in five patients with glioma developed clinical depression in the 6 months after starting radiotherapy. Patients with functional impairment or previous depression were at higher risk. MDD often persisted for at least 3 months. Clinicians should seek and treat depression in adults with glioma.
authors: Edinburgh Centre for Neuro-Oncology, Western General Hospital, Edinburgh, United Kingdom. a.rooney@nhs.net
authors: Alasdair G
authors: AG
authors: Rooney
authors: Shanne
authors: S
authors: McNamara
authors: Mairi
authors: M
authors: Mackinnon
authors: Mary
authors: M
authors: Fraser
authors: Roy
authors: R
authors: Rampling
authors: Alan
authors: A
authors: Carson
authors: Robin
authors: R
authors: Grant
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000532:radiotherapy; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005910:Glioma / Q000150:complications* / Q000532:radiotherapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies