Fatigue, depression, and insomnia: evidence for a symptom cluster in cancer.
OBJECTIVE
To review the evidence for considering fatigue, depression, and insomnia as a symptom cluster in cancer.


METHODS
Empirical studies, clinical articles, and review articles.


CONCLUSIONS
The single- and multi-symptom measurement approaches are of limited usefulness in distinguishing fatigue, depression, and insomnia. Studies in which these symptoms have been measured concurrently in patients with cancer yield consistent evidence of high positive correlations. Results do not appear to be solely a function of overlap in measurement approaches.


CONCLUSIONS
Successful management of fatigue, depression, and insomnia in cancer patients are likely to combine pharmacologic and nonpharmacologic therapies.
Donovan
Kristine A
KA
Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA. kristine.donovan@moffitt.org
Jacobsen
Paul B
PB
D016000:Cluster Analysis; D003863:Depression / Q000503:physiopathology*; D005221:Fatigue / Q000503:physiopathology*; D006801:Humans; D009369:Neoplasms / Q000503:physiopathology*; D007319:Sleep Initiation and Maintenance Disorders / Q000503:physiopathology*