P12.38.A PSYCHIATRIC SYMPTOMS IN GLIOMAS: A SYSTEMATIC REVIEW

Abstract BACKGROUND Gliomas represent the most prevalent and aggressive category of primary central nervous system tumors, frequently associated with neurological and cognitive impairments. Despite their significant prevalence and clinical impact, psychiatric symptoms in this population remain under-recognised and insufficiently addressed. This systematic review aimed to investigate the prevalence and characteristics of psychiatric manifestations in patients with glioma. MATERIAL AND METHODS A systematic search of PubMed, PsycINFO, and Web of Science was conducted to identify studies examining psychiatric symptoms in patients with gliomas. The search strategy combined terms related to glioma subtypes and a broad range of psychiatric conditions. The selection of psychiatric disorders was guided by the diagnostic categories listed in the DSM-5-TR. We adopted the PRISMA statement and used Delphi rounds among all the authors to assess eligibility and the Cochrane Risk-of-Bias tool to evaluate the RoB of the included studies. RESULTS By April 19, 2025, a total of 2,863 articles were screened, and 123 studies met the inclusion criteria. Anxiety and depressive symptoms were the most frequently reported psychiatric manifestations in patients with glioma, whereas other psychiatric syndromes were poorly assessed. The prevalence of depressive symptoms among patients ranged from 20% to 70%, while anxiety symptoms were reported in 30% to 60% of cases. Psychiatric symptoms often preceded neurological signs and were associated with poorer survival, particularly in patients with low-grade gliomas. The severity of psychiatric symptoms correlated with inflammatory biomarkers and tumor prognosis. Notably, only a minority of patients received appropriate treatment. CONCLUSION The findings highlight the substantial, yet often under-recognised, load of psychiatric symptoms in patients with glioma and underscore the need for integrated neuro-psychiatric care. Though the relationship between depression, anxiety and gliomas is established, further evidence is needed to define prevalence, predictors and impact of other psychiatric dimensions in patients with glioma.