Network structure of depression and anxiety symptoms in Chinese female nursing students

BMC Psychiatry

Jiaxi Peng¹  Fengzhan Li²  Lei Ren²  Qun Yang²  Lin Wu²  Long-Biao Cui²  Yinchuan Jin²  Xufeng Liu²  Yifei Wang²  Zihan Wei³  Xinyi Wei⁴  Xinyu Hu⁵ 

[1]College of Teachers, Chengdu University, 610106, Chengdu, China

[2]Department of Military Medical Psychology, Air Force Medical University, 710032, Xi’an, China

[3]Department of Neurology, Xijing Hospital, Air Force Medical University, 710032, Xi’an, China

[4]Department of Psychology, Renmin University of China, 100000, Beijing, China

[5]Department of Psychology, Social Science, University of California, 92614, Irvine, California, USA

关键词: Depression;    Anxiety;    Comorbidity;    Suicide ideation;    Network analysis;    Female nursing students;   

DOI  :  10.1186/s12888-021-03276-1

来源: Springer

【 摘 要 】

BackgroundComorbidity between depressive and anxiety disorders is common. From network perspective, mental disorders arise from direct interactions between symptoms and comorbidity is due to direct interactions between depression and anxiety symptoms. The current study investigates the network structure of depression and anxiety symptoms in Chinese female nursing students and identifies the central and bridge symptoms as well as how other symptoms in present network are related to depression symptom “thoughts of death”.MethodsTo understand the full spectrum of depression and anxiety, we recruited 776 Chinese female nursing students with symptoms of depression and anxiety that span the full range of normal to abnormal. Depression symptoms were measured by Patient Health Questionnaire-9 while anxiety symptoms were measured by Generalized Anxiety Disorder 7-Item Questionnaire. Network analysis was used to construct networks. Specifically, we computed the predictability, expected influence and bridge expected influence for each symptom and showed a flow network of “thoughts of death”.ResultsNine strongest edges existed in network were from the same disorder. Four were between depression symptoms, like “sleep difficulties” and “fatigue”, and “anhedonia” and “fatigue”. Five were between anxiety symptoms, like “nervousness or anxiety” and “worry too much”, and “restlessness” and “afraid something will happen”. The symptom “fatigue”, “feeling of worthlessness” and “irritable” had the highest expected influence centrality. Results also revealed two bridge symptoms: “depressed or sad mood” and “irritable”. As to “thoughts of death”, the direct relations between it and “psychomotor agitation/retardation” and “feeling of worthlessness” were the strongest direct relations.ConclusionsThe current study highlighted critical central symptoms “fatigue”, “feeling of worthlessness” and “irritable” and critical bridge symptoms “depressed or sad mood” and “irritable”. Particularly, “psychomotor agitation/retardation” and “feeling of worthlessness” were identified as key priorities due to their strongest associations with suicide ideation. Implications for clinical prevention and intervention based on these symptoms are discussed.

【 授权许可】

CC BY