Published online Sep 22, 2015. doi: 10.5498/wjp.v5.i3.273
Peer-review started: May 8, 2015
First decision: July 10, 2015
Revised: August 15, 2015
Accepted: September 7, 2015
Article in press: September 8, 2015
Published online: September 22, 2015
Processing time: 144 Days and 1.3 Hours
Infrequently, psychiatric symptoms may be the only manifestation of brain tumors. They may present with mood symptoms, psychosis, memory problems, personality changes, anxiety, or anorexia. Symptoms may be misleading, complicating the clinical picture. A comprehensive review of the literature was conducted regarding reports of brain tumors and psychiatric symptoms from 1956-2014. Search engines used include PubMed, Ovid, Psych Info, MEDLINE, and MedScape. Search terms included psychiatric manifestations/symptoms, brain tumors/neoplasms. Our literature search yielded case reports, case studies, and case series. There are no double blind studies except for post-diagnosis/-surgery studies. Early diagnosis is critical for improved quality of life. Symptoms that suggest work-up with neuroimaging include: new-onset psychosis, mood/memory symptoms, occurrence of new or atypical symptoms, personality changes, and anorexia without body dysmorphic symptoms. This article reviews the existing literature regarding the diagnosis and management of this clinically complex condition.
Core tip: Psychiatric symptoms may rarely be the only presentation of a brain tumor. Any type of psychiatric symptoms can occur with brain tumors. Unfortunately, the symptoms generally do not have any localizing value. New onset psychosis, mood or memory symptoms, occurrence of new or atypical symptoms, personality changes and anorexia without body dysmorphic symptoms, suggest a work up including neuroimaging. Early diagnosis is critical for improved quality of life for the patient.