Resilience levels, associated factors, and their correlation with serum neurotransmitter levels in patients with gastric cancer

doi:10.5498/wjp.v16.i3.111988

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Mar 19, 2026 (publication date) through Feb 27, 2026

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Mar 19, 2026; 16(3): 111988
Published online Mar 19, 2026. doi: 10.5498/wjp.v16.i3.111988

Resilience levels, associated factors, and their correlation with serum neurotransmitter levels in patients with gastric cancer

Neng Shen, Heng-Ke Wu, Xue-Mei Huang

Neng Shen, Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing 400030, China

Heng-Ke Wu, Oncology Treatment Center of Traditional Chinese Medicine, Chongqing University Cancer Hospital, Chongqing 400030, China

Xue-Mei Huang, Department of Clinical Laboratory, Chongqing University Cancer Hospital, Chongqing 400030, China

Co-first authors: Neng Shen and Heng-Ke Wu.

Author contributions: Shen N and Wu HK designed the research and wrote the first manuscript, conducted the analysis and provided guidance for the research, and they contributed equally to this manuscript and are co-first authors; Shen N, Wu HK and Huang XM contributed to conceiving the research and analyzing data. All authors reviewed and approved the final manuscript.

Institutional review board statement: The study was approved by the Institutional Review Board of Chongqing University Cancer Hospital.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: No additional data are available.

Corresponding author: Xue-Mei Huang, Department of Clinical Laboratory, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. 661203@cqu.edu.cn

Received: September 3, 2025
Revised: October 23, 2025
Accepted: December 12, 2025
Published online: March 19, 2026
Processing time: 177 Days and 0.3 Hours

Abstract

BACKGROUND

Although the pathogenesis and management of gastric cancer (GC) have made significant progress, patient prognosis remains unsatisfactory. Patients’ psychological well-being should also be prioritized in addition to their physical health.

AIM

To investigate resilience among GC patients, identify determinants, and examine its association with serum neurotransmitters (NTs).

METHODS

We recruited 141 GC cases (research group) and 120 healthy individuals (control group). Surveys were conducted for all participants, encompassing the Connor-Davidson Resilience Scale (for resilience assessment), the Medical Coping Modes Questionnaire (for coping strategy evaluation), the General Self-Efficacy Scale (for self-efficacy quantification), and the Self-Rating Anxiety Scale/Self-Rating Depression Scale (for emotional distress measurement). Analyses were then conducted to identify inter-group differences in serum NTs, to pinpoint correlations between NTs and resilience (via Spearman’s test), and to determine resilience-associated predictors (using multivariate analysis).

RESULTS

The group scored 65.44 ± 6.97 (mean) on the global Connor-Davidson Resilience Scale (tenacity: 34.70 ± 5.32, self-improvement: 21.13 ± 3.91, optimism: 99.61 ± 1.40). Regarding coping styles, the confrontation, avoidance, and resignation dimension scores were 17.45 ± 1.56, 17.22 ± 1.47, and 10.01 ± 1.08, respectively. The mean self-efficacy score (General Self-Efficacy Scale) was 27.00 ± 3.74. GC cases exhibited reduced serum dopamine, 5-hydroxytryptamine, and norepinephrine than controls (P < 0.05). As to resilience-associated predictors, males, higher education, and greater per capita monthly income were all independently linked to higher resilience, while elevated anxiety/depressive symptoms and advanced-stage cancer showed an inverse correlation with resilience.

CONCLUSION

Reduced resilience and serum NTs, with the two being strongly correlated, are common in GC patients. Clinically, targeted psychological support is critical, particularly for those at-risk populations (e.g., females, lower socioeconomic status, limited education).

Keywords: Gastric cancer; Resilience level; Self-efficacy; Serum neurotransmitters; Psychological healthy

Core Tip: Being a prevalent malignancy, gastric cancer (GC) poses a great threat to patients’ physical and mental health. Despite the presence of extensive research on resilience’s psychological impact, insufficient evidence is available regarding its determinants in GC, with limited theoretical and variable inclusion frameworks. This investigation clarifies the variation in neurotransmitters between GC patients and healthy controls to elucidate how altered neurotransmitter levels influence patients’ resilience, while also identifying resilience-related determinants.