Alleviating Excessive Worries Improves Co-Occurring Depression and Pain in Adolescent and Young Adult Cancer Patients: A Network Approach

Wengao Li; Yining Xu; Xian Luo; Youlu Wen; Kairong Ding; Wenjing Xu; Samradhvi Garg; Yuan Yang; Hengwen Sun

doi:10.2147/NDT.S376408

Alleviating Excessive Worries Improves Co-Occurring Depression and Pain in Adolescent and Young Adult Cancer Patients: A Network Approach

Neuropsychiatr Dis Treat. 2022 Aug 25:18:1843-1854. doi: 10.2147/NDT.S376408. eCollection 2022.

Authors

Wengao Li^#¹, Yining Xu^#², Xian Luo^#³, Youlu Wen¹, Kairong Ding^{4

5}, Wenjing Xu^{6

7}, Samradhvi Garg⁸, Yuan Yang⁵, Hengwen Sun⁷

Affiliations

¹ Department of Psychiatry, Guangdong 999 Brain Hospital, Guangzhou, Guangdong, 510515, People's Republic of China.
² Department of Nursing, Guangzhou First People's Hospital, the Second Affiliated Hospital, South China University of Technology, Guangzhou, Guangdong, 510000, People's Republic of China.
³ Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, 510515, People's Republic of China.
⁴ Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.
⁵ Guangdong Mental Health Center,Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, 510080, People's Republic of China.
⁶ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.
⁷ Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, Guangdong, 510080, People's Republic of China.
⁸ School of Health in Social Science, University of Edinburgh, Edinburgh, EH8 9BL, UK.

^# Contributed equally.

Abstract

Objective: Anxiety, depression, and pain are highly interactive with each other in adolescent and young adult (AYA) cancer patients. This study aims to map out the connectivity between anxiety, depression and pain symptoms amongst Chinese AYA cancer patients from the perspective of a network model.

Methods: Two hundred and eighteen AYA patients, aged between 15 and 39 years at diagnosis; completed the Patient Health Questionnaire (PHQ), Generalized Anxiety Disorder (GAD), and McGill Pain Questionnaire-Visual Analogue Scale (MPQ-VAS). Network analyses were performed.

Results: In all, 38.07% (95% CI = 31.58-44.57%) of the participants reported depression, 30.73% (95% CI = 24.56-36.91%) reported anxiety, and 14.22% (95% CI = 9.55-18.89%) reported current pain. The generated network illustrated that anxiety, depression and pain community were well connected. In the network, "having trouble relaxing" (GAD4, node strength = 1.182), "uncontrollable worry" (GAD2, node strength = 1.165), and "sad mood" (PHQ2, node strength = 1.144) were identified as the most central symptoms, while "uncontrollable worry" (GAD2, bridge strength = 0.645), "guilty" (PHQ6, bridge strength = 0.545), and "restlessness" (GAD5, bridge strength = 0.414) were the key bridging symptoms that connected different communities.

Conclusion: Anxiety, depression and pain symptoms are highly interactive with each other. Alleviating AYA cancer patient's excessive worries might be helpful in improving the patient's co-occurring anxiety, depression and pain symptoms.

Keywords: adolescent; anxiety; cancer; depression; network; pain; young adult.

Grants and funding

This study was supported in part by the National Natural Science Foundation of China (72101107); the Clinical Research Program of Nanfang Hospital, Southern Medical University (2021CR014), and the Start-up Funds of Guangdong Provincial People's Hospital (KY0120211134).