Stress Response During a Three-Month Follow-Up of a Historical Cohort of People with Cancer: Subjective Hyper-Energy and the DYMERS Framework for a Future Preventive Approach

Background: This study examined whether baseline subjective hyper-energy was associated with depressive symptom changes over three months in people with cancer. Methods: This secondary exploratory analysis used a historical oncology cohort of 263 participants. Subjective hyper-energy was defined using SF-12 (Short Form Health Survey 12-item) item 10, and depressive symptoms were assessed with the PHQ-9 (Patient Health Questionnaire, 9-item) at baseline and follow-up. Inverse-probability weighting (IPW) examined attrition bias. Results: Follow-up PHQ-9 data were available for 112 participants (42.6%). At baseline, PHQ-9 scores were lower with than without subjective hyper-energy (4.27 ± 3.42 vs. 7.48 ± 4.39; p < 0.001). At follow-up, the difference was smaller and nonsignificant (5.61 ± 3.85 vs. 7.04 ± 3.71; p = 0.068). Unweighted scores increased by 1.33 ± 4.28 points with subjective hyper-energy and decreased by 0.44 ± 3.33 points without it (p = 0.020). After IPW, the between-group difference in change was attenuated to 0.99 points (95% CI −0.73 to 2.76). Conclusions: Baseline subjective hyper-energy was associated with fewer concurrent depressive symptoms. Although its association with subsequent change was attenuated after IPW, subjective hyper-energy may represent a potentially informative characteristic deserving further investigation within the Dysregulation of Mood, Energy, and Social Rhythms (DYMERS) framework. Prospective studies with validated multidimensional measures are needed to clarify its relationship with depressive worsening and rhythm dysregulation.