Incidence and Characteristics of Psychiatric Disorders in Adolescent and Young Adult Patients with Malignant Brain Tumors.
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PURPOSE: Adolescents and young adults (AYAs) with brain tumors are at an increased risk of developing psychiatric disorders. We aimed to investigate the incidence and characteristics of psychiatric disorders in AYA patients with brain tumors. METHODS: Using the Korean Classification of Diseases, we identified a cohort of AYA patients (aged 15-34 years) diagnosed with malignant brain neoplasms (C71) between 2003 and 2016 from the Korean National Health Insurance Claims Database. The analysis included 7052 patients. RESULTS: The 10-year cumulative incidence rate of psychiatric disorders was 21.5%. The most common psychiatric disorders were neurotic, stress-related, and somatoform disorders (11.4%), followed by mood (affective) disorders (9.4%). Factors associated with a higher incidence of psychiatric disorders included female sex (hazard ratio [HR] 1.16, 95% confidence interval [CI]: 1.05-1.28, p = 0.005), history of seizures (HR: 1.47, 95% CI: 1.31-1.66, p < 0.001), and brain tumor diagnosis during the latter part of the study period (HR: 1.14, 95% CI: 1.03-1.27, p = 0.010). Psychiatric hospital admissions were most frequent among patients with schizophrenia, schizotypal disorders, and delusional disorders (n = 5). The most common psychiatric disorders requiring psychotherapy were neurotic, stress-related, and somatoform (n = 580) and mood (n = 526) disorders. CONCLUSION: A significant number of AYA patients with brain tumors develop psychiatric disorders after diagnosis, and most require treatment. Early detection through screening programs and personalized psychological support during and after cancer treatment may improve the mental health and quality of life of AYA patients with brain tumors.