Introduction – Primary brain tumors may present with neuro–psychiatric symptoms in a few cases. This study tries to evaluate the prevalence and predictors of various behavioral and psychological manifestations (BPS) of diagnosed cases of primary brain tumors.

Methodology – We conducted a cross–sectional questionnaire based study among consenting patients diagnosed with primary brain tumors at a  Government Medical College and Hospital at Faridabad, Haryana. The behavioral and psychological symptoms were assessed through the Neuropsychiatric Inventory (NPI) having a severity assessor and a Caregiver Distress Scale.

Results – Behavioral and psychological symptoms were present in 36 (72%) out of 50 randomly selected subjects. The commonest symptoms were anxiety, irritability and dysphoria. BPS, their severity and caregiver distress were significantly associated with tumors of size greater than 4 cm, located in frontal/temporal and parietal regions, exhibiting midline shift and mass effect (p<0.05). Caregiver distress was also predicted by psychotic and behavioral type of symptoms as compared to mood symptoms (p<0.05).

Conclusion – Neuropsychiatric symptoms may be the primary presentation and the only clue to the presence of a brain tumor.  Clinicians must have a high index of suspicion in patients with new–onset psychiatric symptoms, having atypical presentations and not responding to standard treatment.