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Late Onset Psychosis in Survivors of Pediatric Central Nervous System Malignancies

Received May 2, 2006; revised October 3, 2006; accepted October 16, 2006. Drs. Turkel, Tishler, and Tavare are affiliated with the Departments of Psychiatry, Pathology, and Pediatrics, University of Southern California Keck School of Medicine, Childrens Hospital Los Angeles, California. Address correspondence to Dr. Turkel, University of Southern California School of Medicine, Childrens Hospital Los Angeles, 4650 Sunset Boulevard #82, Los Angeles, CA 90027; sbturkel{at}usc.edu (e-mail).

Survivors of pediatric intracranial malignancies are at recognized high risk for neurocognitive and psychosocial dysfunction, endocrinopathies, growth abnormalities, and second neoplasms. The late onset of persistent psychosis may represent an additional serious psychiatric consequence of childhood intracranial malignancies. The authors report eight survivors of pediatric intracranial malignancies whose course was complicated by the delayed onset of hallucinations, delusions, and bizarre behavior 2 to 12 years after diagnosis and treatment of brain tumors. The purpose of this report is to alert others to the generally unrecognized risk of psychosis following the treatment of brain tumors in children and adolescents.

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