Female gender is not a proven risk factor for depression in glioma

To the Editor:We read Litofsky and Resnick’s timely and useful reviewof depression in brain tumour patients with interest [1]. Theauthors identified screening for depression as an issuerequiring future study. Because screening is often targetedat high-risk groups, it is important to study the risk factorsfor depression in brain tumour patients.The authors state that female gender is a risk factor fordepression in glioma. It is true that some groups have foundwomen with brain tumours to be more likely than men tobecome depressed [2, 3]. However other researchers havenot, including one of the authors of the review [4–6].We sent a questionnaire to the GP of each glioma patienton our hospital database (Edinburgh, UK), asking whethertheir patient had suffered depression both before and sincethe diagnosis of glioma. The diagnosis of depression wasbased on the clinical judgement of each GP. Response ratewas 68% (100/147; 55% male). A pre-glioma (past medi-cal) history of depression was significantly more likely inwomen (12/45 women compared with 3/55 men;P = 0.004, Fisher’s Exact Test). However following gli-oma presentation the sex difference in depression disap-peared and men were equally as likely as women toexperience depression (12/55 and 12/45 respectively;P = 0.64).Female gender is not a proven risk factor for depressionin glioma. Since general population surveys consistentlyreport that depression is twice as common in women [7],studies reporting a more equal sex distribution fordepression in brain tumours may even suggest a relativelyincreased risk for men.We agree that depression in glioma is a fertile field forresearch. For now we suggest that men and women withglioma should be considered at equal risk of developingdepression, and that efforts should therefore be made toinclude them equally in any proposed screeningprogrammes.References