Looking at individual symptoms: the dynamic network structure of depressive symptoms in cancer survivors and their preferences for psychological care

Abstract

Purpose The majority of depressed cancer survivors do not receive psychological care, possibly because offered care does not align with their experiences and preferences. We examined (1) which depressive symptoms cancer survivors would like to receive psychological care for; (2) how distinct depressive symptoms are related to each other in the contemporaneous and temporal network of depressive symptoms; and (3) whether survivors’ care needs correspond to the interconnectedness of these specific symptoms. Method Fifty-two cancer survivors suffering from at least mild depressive symptoms and were not receiving psychological care filled out a baseline questionnaire about their care needs for distinct depressive symptoms, followed by ecological momentary assessments (EMA) assessing depressive symptoms (14 days, five times a day). Multi-level vector autoregression analysis was used to estimate associations between distinct depressive symptoms as well as their centrality within the network. Results Cancer survivors most strongly preferred to receive care for fatigue, feeling down, little enjoyment, and sleep problems. Fatigue, together with worry and lack of concentration, most strongly predicted the onset of other symptoms. Little enjoyment and feeling down were two of the most central symptoms (i.e., strongly connected to other symptoms) in the contemporaneous network and were most strongly influenced by other symptoms in the temporal network. Conclusions Clinicians can offer specific interventions that target fatigue, as these played an important role in the onset of symptoms and would align with survivors’ needs. Implications for Cancer Survivors Offering such symptom-specific care may increase the uptake of psychological interventions in cancer survivors.

Effectiveness of physical activity interventions on reducing perceived fatigue among adults with chronic conditions: a systematic review and meta-analysis of randomised controlled trials

“…Wilson and Cleary’s health-related quality of life model, highlights the interconnectedness of symptom status, which influences functional health, which influences the general health perception, which consequently influences the overall quality of life 136 . Applying this model to our findings may suggest that improving quality of life in individuals with chronic conditions can be achieved by reducing fatigue symptoms through PA 51 . This perspective could indicate the potential of PA to positively impact the overall well-being and functioning of individuals with chronic conditions.…”

“…PA interventions targeting fatigue often focus on one specific chronic condition rather than addressing the symptom itself, despite its prevalence in various chronic conditions. Interventions targeting fatigue are essential in the onset of symptoms and could align with individuals’ needs 51 . Therefore, gaining a better understanding of fatigue transdiagnostically, could provide valuable insights into the relationship between PA and fatigue.…”

Symptom networks in glioma patients: understanding the multidimensionality of symptoms and quality of life

“…35 A study in cancer survivors with depressive symptoms combined data on supportive care needs with estimated temporaneous symptom networks. 36 The authors identified high scores on fatigue and worrying to be strongly predicted by their scores at the previous time point, suggesting self-reinforcing loops. Also, patients expressed a supportive care need for fatigue, feeling down, little enjoyment, and sleep problems, of which feeling down and little enjoyment were also the most central nodes in the network.…”

Role of Cannabidiol for Improvement of the Quality of Life in Cancer Patients: Potential and Challenges

“…Psychological symptoms including anxiety, depression, stress, fatigue, and mood changes are well known to negatively affect the quality of life in cancer patients [ 101 , 102 ]. As noted above, cancer patients participating in clinical trials of CBD or CBD/THC have reported improvements in assessments of these symptoms.…”