Network connectivity between psychological resilience and depression in prostate cancer patients

Prostate cancer (PCa) patients often experience depression. One possible buffer against stress-related depression is psychological resilience (PR), which has been described as heterogeneous in structure, like major depressive disorder (MDD). Although both of these constructs are central to understanding and assisting distressed PCa patients, no data have been reported on how they connect via network arrays at a component and symptom level. Such information has the potential to inform clinical practice with depressed PCa patients.

Using a cross-sectional design, 555 PCa patients completed the Patient Health Questionnaire-9 (PHQ-9) and the Connor-Davison Resilience Scale (CDRISC). Data were analysed via network analysis.

Network analysis indicated that various CDRISC factors interacted with different PHQ-9 symptoms. For example, trust in one's instincts, tolerance of negative affect, and strengthening effects of stress (CDRISC) was associated with concentration problems and suicidal ideation (PHQ-9); positive acceptance of change, and secure relationships (CDRISC) was linked to low self-worth, anhedonia, fatigue/lethargy, motor problems, depressed mood, and concentration and appetite problems (PHQ-9). Similarly heterogeneous associations were found between individual CDRISC items and PHQ-9 symptoms. Network analytic figures depict both these sets of associations.

As well as confirming the heterogeneous nature of PR and MDD in PCa patients, these findings argue for the further development of 'individualised' medicine approaches when working with PCa patients and their experiences of depression.