Identifying core symptoms of anxiety and depression in colorectal cancer patients: network analysis

Negative emotions, particularly anxiety and depression, are highly prevalent among cancer patients. Due to the unique disease characteristics of colorectal cancer, the coexistence of depression and anxiety is even more common, warranting close attention from clinical practitioners. This study aims to elucidate the characteristics of anxiety and depression symptom networks in patients with colorectal cancer.

A cross-sectional study was conducted among 364 colorectal cancer patients recruited via convenience sampling in a hospital setting. Latent profile analysis was used to classify patients based on their anxiety and depression symptoms. Then network analysis was used to obtain the key nodes and compare the differences in the network structure between patients with and without stoma.

The mean scores for anxiety and depression were 5.93 and 7.23, respectively. Patients were classified into three subgroups. Regression analysis indicated that stoma status, diarrhea/constipation status, pain, and perceived stress significantly predicted subgroup membership. D2(depressed or sad mood) was identified as a key symptom in patients who require intervention, while D8(psychomotor agitation or retardation) served as a bridge symptom between anxiety and depression. Significant differences in network structure were observed between patients with and without an stoma.

Both anxiety and depression were generally at mild levels, with depression severity slightly higher than anxiety. Targeting the identified central and bridge symptoms may help guide intervention efforts for colorectal cancer patients at risk of or suffering from anxiety and depressive symptoms, thereby contributing to the alleviation of these symptoms. Clinicians can use these findings to develop individualized treatment plans tailored to patient-specific needs.