The Impact of Social Support on Anxiety and Depression in Colorectal Cancer Patients: The Mediating Role of Psychological Resilience.

OBJECTIVE

This cross-sectional study examines the effects of multidimensional social support on anxiety and depression symptoms in colorectal cancer patients, with particular focus on the mediating role of psychological resilience in this association.

METHODS

We recruited patients from the Shantou Central Hospital between October 2023 and December 2024 using consecutive recruitment. Participants completed validated instruments: the Perceived Social Support Scale (PSSS), Connor- Davidson Resilience Scale (CD-RISC), and Hospital Anxiety and Depression Scale (HADS). Structural equation modeling (SEM)-based path analysis with maximum likelihood estimation was performed to analyze the mediation pathways after establishing bivariate correlations through Pearson's analysis, using composite scores of the scales (rather than latent variables).

RESULTS

We recruited 268 Chinese colorectal cancer patients (51.49% male, mean age predominantly 45-65 years, 34.33% at Stage Ⅲ and 31.72% at Stage Ⅳ) who received surgery alone or combined with chemotherapy/radiotherapy. The cohort demonstrated moderate resilience levels (58.62 ± 12.14), with mean perceived social support scores of 42.38 ± 10.72 and HADS scores of 22.40 ± 7.62. Significant correlations emerged: social support positively correlated with resilience (r = 0.62, P < 0.01) and negatively with anxiety/depression (r=-0.54, P < 0.01), while resilience showed inverse associations with anxiety/depression (r=-0.67, P < 0.01). The SEM revealed excellent model fit (CFI = 0.97, RMSEA = 0.04). Social support was associated with lower anxiety/depression both directly (β=-0.41, P < 0.001) and indirectly via an association with greater resilience enhancement (β=-0.29, P < 0.01), with resilience accounting for 29.17% of the variance in the social support-anxiety/depression relationship.

CONCLUSIONS

Our findings suggest psychological resilience acts as a partial mediator in the pathway between perceived social support and mental health among colon cancer patients. The results highlight the importance of integrating psychosocial interventions that simultaneously strengthen external support systems and cultivate internal resilience capacities.