QLIF-17. ASSESSING DEPRESSION IN GLIOMA PATIENTS

BACKGROUND: A recent Cochrane review revealed only 5 studies exploring depression in glioma patients with variable incidence of 17% to as high as 49%; and even fewer studies using instruments designed to measure depression severity and therapeutic approaches. METHODS: Patients enrolled in the Neuro-Oncology Branch Natural History study were assessed for depression using the Patient Health Questionnaire (PHQ-9). Validated cut-off scores (≥ 5=mild; ≥ 10=moderate-severe with 88% sensitivity and specificity for major depression) were used to account for depression severity. Presence of one of 2 cardinal symptoms (anhedonia, feeling depressed) was also described. Independent sample t-tests and chi-square tests were used to evaluate group characteristics and differences. RESULTS: 124 patients (male=61%) with median age of 48 (21-75) participated, with Glioblastoma (31%) common and recurrence at 27%. KPS was ≥ 90 in 72%. The average PHQ-9 score was 4.9 (SD=4.4; range 0-19) with 50% scoring ≤ 4.0 and 15% scoring ≥10, indicating possible depression. Patients taking psychotropic medications scored 4.9 points higher than those not (t (118) = -3.0, p=0.003, n=120). Patients with poor KPS (£ 80) scored 2.2 points higher than patients with KPS 3 90 (t (105) = -2.4, p=0.019, n=107). A score of ≥ 10 was associated with psychotropic use (X2(1) = 9.5, P=0.002, n=120), while a score of ≥ 5 was associated with performance status (X2(1) =5.2, 0.023, n=107). Further review revealed that 18 patients (15%) reported at least one of the two cardinal symptoms and of these, only 6 (5%) also reported 5 total items required to diagnose depression. CONCLUSION: High PHQ-9 scores were associated with psychotropic use and lower KPS. Cardinal symptoms of depression were uncommon and scores suggestive of clinical depression were rare (4%). Our findings support the use of standardized scales of depression, paving the way for future studies exploring depression severity over the disease trajectory.