Psychiatric Symptoms Associated with Brain Tumors: A Clinical Enigma

ABSTRACT Patients in psychiatric settings may present with medical conditions, such as brain tumors, which may or may not be associated with neurological symptoms. In some cases, patients may only have psychiatric symptoms, such as mood changes (depression or mania), psychotic symptoms, panic attacks, changes in personality, or memory difficulties. Brain tumors may be detected in patients at their first presentation to mental health services or sometimes in patients with well-established psychiatric diagnoses.This article presents the case of a 29-year-old woman who was treated for >4 years for posttraumatic stress disorder and borderline personality traits, who developed depressive symptoms and memory difficulties. However, she did not develop any major neurological signs or symptoms. Brain imaging showed the presence of a left thalamic tumor, later confirmed as glioblastoma multiforme. She underwent surgical treatment and radiation therapy. With this we show that in some cases, brain tumors can be neurologically silent and only present atypical psychiatric symptoms.

[1]  C. Filley,et al.  Neurobehavioral presentations of brain neoplasms. , 1995, The Western journal of medicine.

[2]  R. Binder.  Neurologically silent brain tumors in psychiatric hospital admissions: three cases and a review. , 1983, The Journal of clinical psychiatry.

[3]  E. Vieta,et al.  Quetiapine monotherapy for mania associated with bipolar disorder: combined analysis of two international, double-blind, randomised, placebo-controlled studies , 2005, Current medical research and opinion.

[4]  J. Small,et al.  Quetiapine in schizophrenia: onset of action within the first week of treatment , 2004, Current medical research and opinion.

[5]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[6]  V. Uribe.  Psychiatric symptoms and brain tumor. , 1986, American family physician.

[7]  Uribe Vm.  Psychiatric symptoms and brain tumor. , 1986 .

[8]  S. Madhusoodanan,et al.  Brain tumor and psychiatric manifestations: a case report and brief review. , 2004, Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists.

[9]  M. Lee,et al.  Brain tumor presenting as anorexia nervosa in a 19-year-old man. , 2003, Journal of the Formosan Medical Association = Taiwan yi zhi.

[10]  A. Jarquin-Valdivia.  Psychiatric symptoms and brain tumors: a brief historical overview. , 2004, Archives of neurology.

[11]  C. Wells,et al.  Manic psychosis in a patient with multiple metastatic brain tumors. , 1979, The Journal of clinical psychiatry.

[12]  G. Sachs,et al.  Quetiapine with lithium or divalproex for the treatment of bipolar mania: a randomized, double-blind, placebo-controlled study. , 2004, Bipolar disorders.

[13]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[14]  S. Kasper,et al.  Maintenance of long-term efficacy and safety of quetiapine in the open-label treatment of schizophrenia , 2004, International clinical psychopharmacology.

[15]  R. Swerdlow,et al.  Right orbitofrontal tumor with pedophilia symptom and constructional apraxia sign. , 2003, Archives of neurology.

[16]  Wells Ce,et al.  Manic psychosis in a patient with multiple metastatic brain tumors. , 1979 .

[17]  G. Klerman,et al.  Secondary mania: manic syndromes associated with antecedent physical illness or drugs. , 1978, Archives of general psychiatry.