title: Fatigue, depression, and insomnia: evidence for a symptom cluster in cancer.
abstract: 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.
authors.affiliation: Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA. kristine.donovan@moffitt.org
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Donovan
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
mesh_terms: 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*