Suicide Risk in Glioblastoma Multiforme: A Brief Review of Risk Factors, Screening, and Prevention.

چکیده اصلی

PURPOSE OF REVIEW: Glioblastoma multiforme (GBM) is an aggressive primary brain tumor associated with poor prognosis, rapid functional decline, and psychological distress. An updated review of the literature is lacking, despite that patients with GBM appear to be among the highest risk for suicide among cancer patients. This review summarizes up-to-date evidence of suicide risk factors, screening approaches, and suicide mitigation strategies in patients with GBM. RECENT FINDINGS: Suicide risk is the highest in the first year following GBM diagnosis. It is also associated with older age, male gender, and tumor-related factors such as supratentorial location. Other factors such as neurocognitive decline and poor functional status may also contribute. Evidence emerging from broader oncology populations suggests that demoralization and existential distress may be factors, though these have not been studied in GBM cohorts. Treatment-related psychiatric adverse effects from corticosteroids, anti-epileptic drugs, chemotherapy, and radiotherapy may also influence psychiatric illness and mediate suicide risk. Screening tools such as the Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale, and Colombia-Suicide Severity Rating Scale have been effectively used to screen for suicide in conjunction with clinical interviewing in GBM patients. Evidence-based suicide reduction interventions include psychotherapy, safety planning, lethal means restriction, and caregiver support. GBM is a diagnosis that is associated with higher rates of suicide than almost all other cancers, and the extant literature identifies demographic and tumor features that are associated with suicide in this population. Effective interventions exist to identify and support these patients. Future studies should systematically measure risk factors identified in broader oncology populations to identify additional GBM-specific risk factors for suicide.

ترجمه فارسی چکیده

گلیوبلاستوما چندگانه (GBM) یک تومانر اصلی تهاجمی مغزی است که با پیش‌آگهی بد، سقوط سریع عملکردی و رنج روانی همراه است. این مرور ادبیات جدید، شواهد به‌روز درباره عوامل خطر خودکشی، رویکردهای غربالگری و استراتژی‌های کاهش خودکشی در بیماران مبتلا به GBM را خلاصه می‌کند. خطر خودکشی در سال اول پس از تشخیص GBM بیشترین میزان است و با سن بالاتر، جنسیت مردانه و عوامل تومانی مانند محل فوق‌سوپراتورنال مرتبط است. ابزارهای غربالگری مانند پرسشنامه سلامت بیمار-9، مقیاس اضطراب و افسردگی بیمارستانی و مقیاس رتبه‌بندی شدت خودکشی کلمبیا، در کنار مصاحبه بالینی، برای غربالگری خودکشی در بیماران GBM مؤثر بوده‌اند. مداخلات مبتنی بر شواهد برای کاهش خودکشی شامل روان‌درمانی، برنامه‌ریزی ایمنی، محدود کردن وسایل کشنده و حمایت از مراقب است.

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