ARTICLE

Depression is a well-recognized complication of cerebral glioma (1–3), but it can be challenging to study (4,5). Primary symptoms of depression are difficult to distinguish from the consequences of tumor or treatment (1,3,6). However, true clinical depression can and does develop following a decline in health (7,8) and is of great practical relevance to patients. Among all cancer patients, those diagnosed with glioma have the highest risk of clinically significant psychiatric complications in the period surrounding their diagno-sis (9,10). Poor mental health has potentially important conse-quences. Depression may adversely affect quality of life (1–3,11) and is an independent predictor of mortality in patients with systemic cancer arising beyond the central nervous system (12). Many things remain unknown about depression in glioma. Depression in these patients has been conceptualized as a biolog-ical disease (3,4,13–16), a psychological reaction to the losses asso