BACKGROUND: Anxiety, depression, insomnia, fatigue, and pain are frequently reported by cancer patients. These symptoms are highly interrelated. However, few prospective studies have documented the sequence with which symptoms occur during cancer care. PURPOSE: This longitudinal study explored the temporal relationships between anxiety, depression, insomnia, fatigue, and pain over an 18-month period in a large population-based sample of nonmetastatic cancer patients (N = 828), using structural equation modeling. METHODS: The patients completed a battery of self-report scales at baseline and 2, 6, 10, 14, and 18 months later. RESULTS: The relationships between the same symptom at two consecutive assessments showed the highest coefficients (β = 0.29 to 0.78; all ps ≤ 0.05). Cross-loading parameters (β = 0.06 to 0.19; ps ≤ 0.05) revealed that fatigue frequently predicted subsequent depression, insomnia, and pain, whereas anxiety predicted insomnia. CONCLUSIONS: Fatigue and anxiety appear to constitute important risk factors of other cancer-related symptoms and should be managed appropriately early during the cancer care trajectory.
BACKGROUND:Anxiety, depression, insomnia, fatigue, and pain are frequently reported by cancerpatients. These symptoms are highly interrelated. However, few prospective studies have documented the sequence with which symptoms occur during cancer care. PURPOSE: This longitudinal study explored the temporal relationships between anxiety, depression, insomnia, fatigue, and pain over an 18-month period in a large population-based sample of nonmetastatic cancerpatients (N = 828), using structural equation modeling. METHODS: The patients completed a battery of self-report scales at baseline and 2, 6, 10, 14, and 18 months later. RESULTS: The relationships between the same symptom at two consecutive assessments showed the highest coefficients (β = 0.29 to 0.78; all ps ≤ 0.05). Cross-loading parameters (β = 0.06 to 0.19; ps ≤ 0.05) revealed that fatigue frequently predicted subsequent depression, insomnia, and pain, whereas anxiety predicted insomnia. CONCLUSIONS:Fatigue and anxiety appear to constitute important risk factors of other cancer-related symptoms and should be managed appropriately early during the cancer care trajectory.
Authors: Sonia Ancoli-Israel; Lianqi Liu; Michelle Rissling; Loki Natarajan; Ariel B Neikrug; Barton W Palmer; Paul J Mills; Barbara A Parker; Georgia Robins Sadler; Jeanne Maglione Journal: Support Care Cancer Date: 2014-04-15 Impact factor: 3.603
Authors: Barbara L Andersen; Robert J DeRubeis; Barry S Berman; Jessie Gruman; Victoria L Champion; Mary Jane Massie; Jimmie C Holland; Ann H Partridge; Kate Bak; Mark R Somerfield; Julia H Rowland Journal: J Clin Oncol Date: 2014-04-14 Impact factor: 44.544