A Network Analysis of Psychosomatic Symptoms in Patients Following Surgery for Differentiated Thyroid Cancer (DTC)

Background Individuals who have survived an instance of differentiated thyroid cancer (DTC) frequently encounter interconnected psychosomatic symptoms that exert an effect on their quality of life. Nevertheless, the dynamics of these relationships remain to be fully elucidated. The objective of this study is to conduct a network analysis of the interconnections among psychosomatic symptoms in DTC patients who have undergone surgery. The objective of this study is to identify the key symptom nodes and to understand how these symptoms interact, thereby shedding light on their impact on quality of life post-surgery. Methods A cross-sectional design was adopted, and 452 postoperative DTC patients hospitalized in the Head and Neck Surgery Department of Cancer Hospital Chinese Academy of Medical Science, Shenzhen Center from May 2024 to May 2025 were selected as subjects. During postoperative follow-up at 2–4 weeks, data were collected using a general information questionnaire, the Thyroid Cancer-specific Quality of Life Scale (THYCA-QoL), and the Hospital Anxiety and Depression Scale (HADS). The symptom network model was constructed using the qgraph package in R software. The EBICglasso algorithm was employed to estimate the symptom network structure. Network characteristics were analyzed by calculating centrality indices including node strength, closeness, betweenness, as well as bridge strength. Results A total of 410 valid samples were included (response rate = 90.7%). Network analysis revealed: (1) Psychological distress (THYCA-QoL6) demonstrated the highest centrality in the network (strength z = 2.15, closeness z = 1.64); (2) A strong correlation was observed between anxiety (HADS-A) and attention difficulties (THYCA-QoL3) (r = 0.76); (3) Anxiety (HADS-A), sensory symptoms (THYCA-QoL7), and attention difficulties (THYCA-QoL3) demonstrated notable bridge effects (bridge strength = 0.86–0.13). Conclusions Psychological distress serves as the central hub in the symptom network of postoperative DTC patients, while anxiety, sensory symptoms, and attention difficulties act as primary bridges for symptom transmission. These findings highlight the clinical importance of addressing patients' psychological well-being during postoperative rehabilitation. Interventions such as mindfulness-based therapy combined with physical rehabilitation are recommended to improve postoperative quality of life.