title: Anxiety in the preoperative phase of awake brain tumor surgery.
abstract: OBJECTIVE
  Awake surgery emerges as a standard of care for brain tumors located in or near eloquent areas. Levels of preoperative anxiety in patients are important, because anxiety can influence cognitive performance and participation, hence altering the outcome of the procedure. In this study we analyzed the prevalence and potential clinical predictors of anxiety in the pre-operative phase of an awake brain tumor surgery.
  
  
  METHODS
  Seventy consecutive candidates for an awake brain tumor surgery were included. All patients received a neuropsychological pre-operative work-up. The Hospital Anxiety and Depression Scale (HADS) was administrated to investigate symptoms of anxiety. Demographic and medical data were extracted from patients' charts. Linear regression analyses, multiple regression analyses, t-tests for parametric and Mann-Whitney U tests for non-parametric data were used to analyze the relation between demographic and medical variables and pre-operative anxiety.
  
  
  RESULTS
  Mean score on the anxiety scale of the HADS was 6.1 (SD=4.2, range 1-19) and 25% of the patients scored on or above the cut-off for anxiety symptoms (score >7). Women reported higher levels of anxiety than men (p<0.01). Furthermore, younger patient were more anxious than older patients (p<0.05). No other variables were significantly related to pre-operative anxiety.
  
  
  CONCLUSIONS
  Merely, one in every four patients reported significant anxiety symptoms in the pre-operative phase. Besides gender and age, none of the other demographic or medical factors were significantly associated with the level of anxiety.
authors.affiliation: Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands. Electronic address: c.ruis@umcutrecht.nl.
authors.forename: Carla
authors.initials: C
authors.lastname: Ruis
authors.affiliation: Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
authors.forename: Irene Huenges
authors.initials: IH
authors.lastname: Wajer
authors.affiliation: Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Pierre
authors.initials: P
authors.lastname: Robe
authors.affiliation: Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands.
authors.forename: Martine
authors.initials: M
authors.lastname: van Zandvoort
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology* / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D014851:Wakefulness / Q000502:physiology*; D055815:Young Adult
keywords: Anxiety; Awake craniotomy; Brain tumor; Surgery