Psychiatric symptoms are prevalent among adults with gliomas, yet their recognition and characterization remain limited. This systematic review aimed to synthesize evidence on prevalence, temporal course, and disease-specific correlates of all reported psychiatric symptoms in adults with glioma. PubMed, CINAHL, and PsycInfo were searched from inception to September 1st, 2025.
Eligible studies enrolled adults with glioma and assessed psychiatric symptoms using validated psychometric instruments or structured/semi-structured clinical interviews. Reporting followed PRISMA guidelines and risk of bias was assessed using the ROBINS-E framework. Among 4327 records, 130 studies met criteria for qualitative synthesis.
Depressive (20-55%) and anxiety (20-58%) symptoms emerged as the most frequent and relevant manifestations. Depressive symptoms were more common in high-grade glioma and were associated with poorer survival and functional impairment, whereas anxiety symptoms were mainly linked to reduced quality of life and showed inconsistent prognostic associations, with distinct phase-dependent patterns across the disease course. Beyond affective disorders, a range of non-affective psychiatric manifestations was identified, including psychotic symptoms, personality traits, sleep disturbances, obsessive symptoms and eating disturbances, and post-traumatic stress symptoms.
These manifestations were less frequently reported and tended to occur in specific clinical contexts, such as the peri-operative or treatment phases, or in association with involvement of specific neuroanatomical regions. Psychiatric symptoms are integral, phase-dependent features of the glioma trajectory, shaped by tumor-related factors and active treatments. Screening and management should be prioritized at clinically high-risk stages.
Future studies should integrate psychiatric assessments with tumor-related variables to refine mechanistic understanding. We express our acknowledgements to all the researchers and collaborators who have conducted studies on this topic. These authors contributed equally: Gabriele Sani, Alessio Simonetti.
Section of Psychiatry, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy Francesca Bardi, Leonardo Monacelli, Romina Caso, Gianmarco Stella, Silvia Montanari, Delfina Janiri & Gabriele Sani Section of Psychiatry, Department of Neuroscience, Head-Neck and Chest, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy Georgios D. Kotzalidis, Silvia Montanari, Delfina Janiri, Gabriele Sani & Alessio Simonetti Patient-Centred Outcomes Research, Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, UK Academic Unit of Health Economics, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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