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Affective state and cognitive functioning in patients with intracranial tumors: validity of the neuropsychological baseline assessment


Correspondence to: Department of Neurosurgery, University Hospital Schleswig-Holstein, Schittenhelmstr. 10, D-24105 Kiel, Germany. E-mail:



The aim of this paper is to investigate the relationship between the affective and cognitive states of neurooncological patients prior to the neurosurgical treatment to assess associations between distress levels and neuropsychological test performance in this sample and setting.


The prospective study population consists of 172 patients. Patients were studied preoperatively with a comprehensive test battery consisting of a variety of affective and cognitive measures. Psychological instruments included the Hospital Anxiety and Depression Scale, the Amsterdam Preoperative Anxiety and Information Scale, and the Acute Stress Disorder Scale.


Factor analysis revealed two factors representing subjective affective functioning: whereas one reflects the patients' more general emotional state (Hospital Anxiety and Depression Scale, Acute Stress Disorder Scale), the second reflects anxiety specifically related to the neurosurgical procedure (Amsterdam Preoperative Anxiety and Information Scale). After age and education have been accounted for via linear regression analyses, affect did not contribute to cognitive performance in any of the cognitive domains in the whole patient sample. However, in patients with extreme levels of psychiatric morbidity, there was evidence for distinct cognitive morbidity consistent with previous research.


Our results suggest that, for a large variety of widely used neuropsychological measures and for most neurooncological patients, the preoperative neuropsychological baseline assessment can be considered valid and dependable. In patients with extreme levels of distress, however, distinct cognitive domains might be differentially affected. Copyright © 2012 John Wiley & Sons, Ltd.