Abstract / Summary
Abstract Background Depressive symptoms, insomnia symptoms and impaired quality of life (QoL) are prevalent among patients with cancer and their caregivers, yet the direct comparisons between both groups remain limited. Hence, this study compared these symptoms and characterized the depression–insomnia symptom networks separately in both groups. Methods This multicenter cross-sectional study included 9,224 hospitalized adult patients with cancer and 8,450 caregivers from seven regions in China. Depressive symptoms, insomnia symptoms, and global QoL were assessed using the Patient Health Questionnaire-9, Insomnia Severity Index-7, and the first two items of the World Health Organization Quality of Life Brief Version, respectively. The associations between both groups and the depressive symptoms, insomnia symptoms and QoL were examined using multivariable regression models. Regularized partial correlation networks were estimated separately for cancer patient and caregiver groups. Results Compared with caregivers, cancer patients had higher PHQ-9 scores (4.30 ± 4.83 vs. 3.23 ± 4.75), higher ISI-7 scores (5.12 ± 5.61 vs. 4.72 ± 6.47), and lower QoL scores (5.93 ± 1.58 vs. 6.57 ± 1.70) (all P < 0.001). After adjustment, patients showed higher odds of mild depressive symptoms (OR = 1.63, 95% CI: 1.50–1.77), moderate-to-severe depressive symptoms (OR = 1.14, 95% CI: 1.01–1.29), insomnia symptoms (OR = 1.41, 95% CI: 1.29–1.55), and lower QoL (β = -0.56, 95% CI: -0.61 to -0.50). Across both groups, network analysis identified fatigue/low energy and insomnia-related or somatic symptoms as the key bridge symptoms between depressive and insomnia symptoms. Conclusions Hospitalized patients with cancer experienced more severe depressive and insomnia symptoms and poorer QoL than caregivers. Fatigue/low energy and sleep-related symptoms might represent important transdiagnostic intervention targets. Clinical trial number Not applicable.