Related Experiment Video
Updated: Jul 19, 2025
Author Spotlight: Unveiling the Connection Between Sleep Disorders and Cognitive Symptoms in Depression
Published on: April 26, 2024
Relationship Between Cortisol Rhythm and Psychoneurological Symptom Cluster in Patients With Advanced Lung Cancer
Naomi Takemura1, Denise Shuk Ting Cheung, Daniel Yee Tak Fong
1Authors' Affiliation: School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Background:
Patients with advanced lung cancer commonly experience a high prevalence of physical and psychological symptoms, which tend to co-occur as a symptom cluster. Cortisol rhythm has the potential to influence psychoneurological symptom cluster based on neuroendocrine-immune models; however, little is known about the relationship between them.
Objective:
To examine the intercorrelation among symptoms in psychoneurological symptom cluster and the factors influencing the severity of psychoneurological symptom cluster.
Methods:
One hundred sixty-one patients with advanced lung cancer were recruited from 2018 to 2020 as part of a large study. Data on sleep disturbances, fatigue, and psychological distress were collected via self-report questionnaires, and the diurnal cortisol slope was analyzed using saliva samples. Linear regression analyses were adopted to examine the association between cortisol rhythm and demographic and clinical variables with psychoneurological symptom cluster.
Results:
Psychoneurological symptoms (including sleep disturbances, fatigue, anxiety, and depression) were significantly correlated. Poor physical performance status (β = -0.061, P < .001), increased number of comorbidities (β = 0.533, P < .001), and flatter cortisol rhythm (β = 545.092, P < .001) were significantly associated with higher-severity psychoneurological symptom cluster. Diurnal cortisol slope (β = 328.829, P = .025) was identified as the most critical factor influencing the psychoneurological symptom cluster in multiple linear regression model after adjusting for covariates.
Conclusions:
Patients with flatter diurnal cortisol slopes were found to experience more severe psychoneurological symptom cluster, after controlling for demographic and clinical factors.
Implications For Practice:
Interventions targeting the improvement of associated factors, such as comorbidities and physical performance status, could potentially alleviate the severity of the psychoneurological symptom cluster.
Related Concept Videos
01:19Psychoneuroimmunology: Diabetes and Cancer
01:27Introduction to Stress and Lifestyle
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:37Hypothalamic-Pituitary Axis
01:27Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...