Research Paper Volume 12, Issue 20 pp 20095—20110

Depressive and anxiety disorders worsen the prognosis of glioblastoma

Xiaojun Fu1,2, , Chenxing Wu1, , Ning Han3, , Ning Liu1, , Song Han1, , Xuebin Liu4, , Shouwei Li1, , Changxiang Yan1, ,

  • 1 Sanbo Brain Hospital, Capital Medical University, Beijing, PR China
  • 2 Capital Medical University, Beijing, PR China
  • 3 Department of Neurosurgery, Chinese PLA Tianjin Rehabilitation and Recuperation Center of Joint Service Support Force, Tianjin, PR China
  • 4 Zhong Guang Tianyi Bio Technology Co., Ltd., Beijing, China

Received: January 18, 2020       Accepted: May 25, 2020       Published: October 28, 2020
How to Cite

Copyright: © 2020 Fu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Glioblastoma multiforme (GBM) is one of the most malignant tumors. Depressive and anxiety disorders may co-exist with GBM. We investigated whether depression and anxiety influenced the outcomes of GBM. The Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales were used to investigate the mental condition of GBM patients in our department, and the overall survival times of these patients were monitored. The scores on both scales were higher in GBM patients than in healthy controls. For each scale, GBM patients were divided into high- and low-score groups based on the average score. The prognosis was poorer for GBM patients in the high-score groups than for those in the low-score groups. Moreover, magnetic resonance imaging revealed that tumor necrosis was more prevalent among high-scored GBM patients. Cellular experiments were performed on primary GBM cells from patients with either high or low scores on both scales. Sphere formation, EdU and wound healing assays revealed greater proliferation and invasion capacities in GBM cells from patients with high scores on both scales. Western blotting assay revealed significantly different expression of epithelial and mesenchymal markers between the two groups. Thus, our analysis revealed a clinically important correlation between depression/anxiety and GBM prognosis.


GBM: glioblastoma multiforme; PHQ-9: Patient Health Questionnaire 9-item; GAD-7: Generalized Anxiety Disorder 7-item; MRI: Magnetic Resonance Imaging; EdU: 5-Ethynyl-2-deoxyuridine.