Correlation of anxiety and depression with sleep quality and post-traumatic growth in brain tumor patients and associated determinants

Abstract

BACKGROUND

Patients with brain tumors (BTs) are often accompanied by anxiety and depression, which are not conducive to improved clinical outcomes.

AIM

To investigate anxiety and depression in relation to sleep quality and post-traumatic growth (PTG) in patients with BTs and identified associated determinants.

METHODS

A total of 169 patients with BTs admitted between October 2022 and January 2025 were enrolled. Data on anxiety and depression (Hospital Anxiety and Depression Scale, HADS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and PTG was collected. Correlation analysis was conducted to evaluate associations between HADS subscales - HADS-Anxiety and HADS-Depression - and PSQI and PTG Inventory (PTGI) scores. Anxiety or depression-associated determinants were identified using univariate screening followed by binary logistic regression analysis.

RESULTS

Among the 169 patients with BTs, the prevalence of anxiety, depression, anxiety-depression comorbidity, and either anxiety or depression was 34.91%, 30.18%, 10.65%, and 54.44%, respectively. The four most PSQI dimensions were sleep latency, sleep duration, daytime dysfunction, and sleep quality. The mean PTGI score was 59.89 ± 8.83, with 47.93% of patients scoring < 60. The correlation analysis demonstrated positive correlations between HADS-Anxiety and HADS-Depression scores and PSQI, and negative correlations with PTGI. Regression analysis showed that age, educational level, PSQI, and PTGI independently influenced anxiety or depression in patients with BTs.

CONCLUSION

Anxiety and depression in patients with BTs are closely associated with sleep quality and PTG. Age ≥ 50 years, high school education, and PTGI ≥ 60 exert protective effects against anxiety or depression, whereas PSQI ≥ 11 independently increases the risk.

Keywords: Brain tumor; Anxiety; Depression; Sleep quality; Post-traumatic growth; Correlation analysis and determinants

Core Tip: This study reports the correlations between anxiety, depression, sleep quality, and post-traumatic growth (PTG) in patients with brain tumors (BTs) and identifies related influencing factors. The findings indicate that patients with BT commonly experience negative emotions such as anxiety and depression, accompanied by relatively severe sleep disorders and insufficient PTG. These negative emotional states are strongly associated with sleep quality and PTG. Factors, including age < 50 years, educational level below high school, PTG-inventory score < 60, and Pittsburgh Sleep Quality Index score ≥ 11, increases the likelihood of anxiety or depression in patients with BTs.