Psychiatric aspects of tumours of the central nervous system

Abstract

Abstract: The incidence of brain tumours has increased in recent years. They represent the second most common cause of death attributable to neurological conditions. Although expansive brain lesions often lead to observation by Neurology or Neurosurgery, it is not uncommon for psychiatric symptoms to be the reason for initial contact with medical care. Brain tumours may present as symptomatology similar to the so-called primary, or functional, psychiatric disorders. However, in contrast to psychiatric disease in other types of cancer, where adjustment disorders predominate, organic syndromes are the most frequent diagnosis in patients with CNS tumours. Anatomic location represents one of several factors that contribute to the nature and severity of psychiatric conditions. Tumours of the frontal lobe are more frequently associated with changes in executive function, amotivational syndrome and personality changes. Temporal tumours can trigger psychotic symptoms such as hallucinations and delusions. The treatment of the symptomatology will essentially involve removal of the lesion whenever possible. Nevertheless, symptomatic treatment of psychiatric manifestations should always take place. Psychopharmacology, psychotherapy and psychoeducation of caregivers are the best modes of treatment.