The facets of psychopathology in patients with cancer: Cross-sectional and longitudinal network analyses

易怒 精神病理学 焦虑 敌意 心理学 纵向研究 恐慌 临床心理学 悲伤 惊恐障碍 精神科 苦恼 愤怒 萧条(经济学) 医学 宏观经济学 病理 经济
作者
Martino Belvederi Murri,Rosangela Caruso,Alexander P. Christensen,Federica Folesani,Maria Giulia Nanni,Luigi Grassi
出处
期刊:Journal of Psychosomatic Research [Elsevier BV]
卷期号:165: 111139-111139 被引量:7
标识
DOI:10.1016/j.jpsychores.2022.111139
摘要

Cancer patients display heterogeneous psychopathology, comprising depressive, anxiety, hostility, and somatic symptoms. Often, clinical pictures evolve over time deteriorating the individual functioning and prognosis. Network models can reveal the relationships between symptoms, thus providing clinical insights.This study examined data of the Brief Symptom Inventory and the Distress Thermometer, from 1108 cancer outpatients. Gaussian Graphical Models were estimated using regularized and non-regularized Bayesian methods. In addition, we used community detection methods to identify the most relevant symptom groupings, and longitudinal network analyses on 515 participants to examine the connections between symptoms over three months.The network models derived from baseline data suggested symptoms clustered into three main complexes (depression/anxiety, hostility, and somatic symptoms). Symptoms related to depression and hostility were highly connected with suicidal and death thoughts. Faintness, weakness, chest pain, and dyspnoea, among somatic symptoms, were more strongly connected with psychopathological features. Longitudinal analyses revealed that sadness, irritability, nervousness, and tension predicted each other. Panic and death thoughts predicted fearfulness and faintness.Somatic symptoms, sadness, irritability, chronic and acute anxiety interact between each other, shaping the heterogeneous clinical picture of distress in cancer. This study, strengthened by robust methods, is the first to employ longitudinal network analyses in cancer patients. Further studies should evaluate whether targeting specific symptoms might prevent the onset of chronic distress and improve clinical outcomes in cancer patients.
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