The network structures of depressive and insomnia symptoms among cancer patients using propensity score matching: Findings from the Health and Retirement Study (HRS)

TitleThe network structures of depressive and insomnia symptoms among cancer patients using propensity score matching: Findings from the Health and Retirement Study (HRS)
Publication TypeJournal Article
Year of Publication2024
AuthorsChen, M-Y, Bai, W, Wu, X-D, Sha, S, Su, Z, Cheung, T, Pang, Y, Ng, CH, Zhang, Q, Xiang, Y-T
JournalJournal of Affective Disorders
ISSN Number0165-0327
KeywordsCancer, depression, insomnia, Network analysis
Abstract

Objective Both depression and insomnia are found to be more prevalent in cancer patients compared to the general population. This study compared the network structures of depression and insomnia among cancer patients versus cancer-free participants (controls hereafter). Method The 8-item Center for Epidemiological Studies Depression Scale (CESD-8) and the 4-item Jenkins Sleep Scale (JSS-4) were used to measure depressive and insomnia symptoms, respectively. Propensity score matching (PSM) was used to construct the control group using data from the Health and Retirement Study (HRS). In total, a sample consisted of 2216 cancer patients and 2216 controls was constructed. Central (influential) and bridge symptoms were estimated using the expected influence (EI) and bridge expected influence (bridge EI), respectively. Network stability was assessed using the case-dropping bootstrap method. Result The prevalence of depression (CESD-8 total score ≥ 4) in cancer patients was significantly higher compared to the control group (28.56 % vs. 24.73 %; P = 0.004). Cancer patients also had more severe depressive symptoms relative to controls, but there was no significant group difference for insomnia symptoms. The network structures of depressive and insomnia symptoms were comparable between cancer patients and controls. “Felt sadness” (EI: 6.866 in cancer patients; EI: 5.861 in controls), “Felt unhappy” (EI: 6.371 in cancer patients; EI: 5.720 in controls) and “Felt depressed” (EI: 6.003 in cancer patients; EI: 5.880 in controls) emerged as the key central symptoms, and “Felt tired in morning” (bridge EI: 1.870 in cancer patients; EI: 1.266 in controls) and “Everything was an effort” (bridge EI: 1.046 in cancer patients; EI: 0.921 in controls) were the key bridge symptoms across both groups. Conclusion Although cancer patients had more frequent and severe depressive symptoms compared to controls, no significant difference was observed in the network structure or strength of the depressive and insomnia symptoms. Consequently, psychosocial interventions for treating depression and insomnia in the general population could be equally applicable for cancer patients who experience depression and insomnia.

DOI10.1016/j.jad.2024.04.035
Citation KeyCHEN2024