Brain tumors (BT) sometimes present with psychiatric symptoms, with or without neurological ones, and BT patients with psychiatric symptoms are sometimes mistakenly oriented towards psychiatric/psychological care. Case studies concluded that atypical psychiatric symptoms should lead to neurological investigation, but no description of such atypical symptoms has been provided.

The present study aims to quantify the prevalence and further describe psychiatric symptoms occurring before a BT diagnosis.

We aim to sensitize physicians to consider more systematically neurological options, and to provide them with a description of atypical pattern of psychiatric symptoms occurring in patients with BT.

Fifty patients with a first diagnosis of BT (21 males and 29 females, aged 25-81 years) completed an anamnestic interview, the Mini International Neuropsychiatric Interview, and the Beck Depression Inventory (BDI-II), in order to investigate and describe current and past psychiatric symptoms. A neuropsychological evaluation was also conducted.

Most patients (45/50) reported at least one psychiatric symptom during the months before the BT diagnosis. About half of them presented anxious or depressive symptoms according to the clinical interviews and the BDI-II. Interestingly, somatic symptoms of depression (tiredness, slower reactions, appetite changes…) were often reported, in contrast to cognitive ones (guilt, self-criticalness…). The influence of the BT characteristics and the neuropsychological profile will be discussed.

The results confirm the frequent occurrence of psychiatric symptoms before a BT diagnosis and provide a first description of these symptoms, as the basis of future recommendations for physicians.