Psychiatric Considerations in Pediatric Patients With Brain Tumors.

Objective: Adolescents diagnosed with brain or central nervous system tumors face elevated levels of depression and anxiety compared to the general pediatric population. The objective of this review was to explore factors associated with elevated depression and anxiety symptoms in these patients, as well as various currently recommended interventions. Data Sources: Articles were searched in PubMed and filtered to select for the following MeSH keywords: brain neoplasm, mental health, behavioral symptom, mental disorder AND (child* OR adolescen* OR teen* OR youth OR pediatr*). Articles were limited to those published in English between 2000 and 2020. Study Selection: A total of 1,537 articles were retrieved, and 36 studies were reviewed. Articles were selected if they pertained to human subjects, specifically adolescents aged ≤ 18 years. Additionally, only articles about depression and anxiety were included. Symptoms of depression and anxiety before a brain tumor diagnosis or as symptoms of a possible brain tumor were excluded. Data Extraction: Articles were screened by title and abstract as they pertained to depression and anxiety in patients diagnosed with brain tumors in adolescence. Data extracted included information about risk factors associated with depression and anxiety, interventions, and pharmacologic considerations. Results: Factors associated with increased depressive and anxiety symptoms include intensity of cancer treatment, female sex, and brain tumor diagnosis. Pediatric brain tumor patients also experience elevated antidepressant prescription rates. When treating depression and anxiety in these patients, it is also important to focus on multifaceted interventions like behavioral and communication therapies, as the nature of brain tumors can affect psychological, social, and cognitive abilities. Conclusions: Depression and anxiety can have long-lasting effects on pediatric brain tumor patients and put them at risk for developing other psychosocial problems. Therefore, it is important to recognize factors contributing to depression and anxiety as well as potential interventions.