Activity restriction contributes to worse mental health in cancer survivors

Activity restriction (AR) appears to mediate the relationship between perceived pain and depression in cancer survivors, a new study has found.

Researchers administered a batter of questionnaires to 61 cancer survivors (mean age, 56.39±11.91 years; 62.3 percent male), including the Pain Catastrophizing Scale, the Cancer Fatigue Scale, the Activity Restriction Scale for Cancer patients, and the Hospital Anxiety and Depression Scale. Prostate cancer was the most prevalent diagnosis in the study sample (60.7 percent).

AR was significantly different across various types of cancer treatments. Those who received surgery, for instance, were more restricted than those who had not (p<0.05). These patients also tended to have greater depression scores (p<0.001).

Pearson’s correlation analysis found that perceived pain and fatigue were both significantly associated with depression, with r values ranging from 0.36–0.74. AR was likewise correlated with depression (r, 0.55; p<0.001).

Mediation analysis, with depression as the dependent variable, showed that AR was a significant mediator between perceived pain and depression (p<0.005), notwithstanding the significant and direct link between perceived pain and depression (p<0.001).

On the other hand, while fatigue was directly associated with depression (p<0.005), AR played no such significant mediating role.

“While in depressive symptomatology of cancer survivors, physical symptoms tend to be treated as predictors of depressive symptoms, our study suggests that the psychological restriction of daily life activities may have a greater effect on depressive symptoms in cancer survivors,” said researchers.

“Furthermore, because AR was experienced in the context of a survivorship period, it may need to be treated as a long long-term effect of the cancer diagnosis,” they added.