Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic*

JOURNAL OF AFFECTIVE DISORDERS

卷:294

Article

Bai, Wei^1,2,3,4  Xi, Hai-Tao⁵  Zhu, Qianqian^6,7,8,9  Ji, Mengmeng¹⁰  Zhang, Hongyan¹¹  Yang, Bing-Xiang¹²  Cai, Hong^1,2,3,4  Zhao, Yan-Jie^1,2,3,4  Chen, Li⁵  Ge, Zong-Mei⁵  Wang, Zhiwen¹⁰  Chen, Pan¹²  Liu, Shuo¹²  Cheung, Teris¹³  Tang, Yi-Lang^12,14  Jackson, Todd¹⁵  An, Fengrong^7,8,9  Xiang, Yu-Tao^1,2,3,4 

[1] Univ Macau, Dept Publ Hlth & Med Adm, Unit Psychiat, Macau, Peoples R China

[2] Univ Macau, Fac Hlth Sci, Inst Translat Med, Macau, Peoples R China

[3] Univ Macau, Ctr Cognit & Brain Sci, Macau, Peoples R China

[4] Univ Macau, Inst Adv Studies Humanities & Social Sci, Macau, Peoples R China

[5] Jilin Univ, Coll Nursing, Jilin, Jilin, Peoples R China

[6] Capital Med Univ, Sch Nursing, Beijing, Peoples R China

[7] Capital Med Univ, Sch Mental Hlth, Natl Clin Res Ctr Mental Disorders, Beijing, Peoples R China

[8] Capital Med Univ, Sch Mental Hlth, Beijing Anding Hosp, Beijing Key Lab Mental Disorders, Beijing, Peoples R China

[9] Capital Med Univ, Sch Mental Hlth, Adv Innovat Ctr Human Brain Protect, Beijing, Peoples R China

[10] Peking Univ, Sch Nursing, Beijing, Peoples R China

[11] Lanzhou Univ, Sch Nursing, Lanzhou, Gansu, Peoples R China

[12] Atlanta VA Med Ctr, Decatur, GA USA

[13] Hong Kong Polytech Univ, Sch Nursing, Hong Kong, Peoples R China

[14] Emory Univ, Dept Psychiat & Behav Sci, Atlanta, GA 30322 USA

[15] Univ Macau, Dept Psychol, Taipa, Macao, Peoples R China

关键词: Depression;    Anxiety;    Nursing students;    Network analysis;    COVID-19;   

DOI  :  10.1016/j.jad.2021.07.072

来源: Elsevier

【 摘 要 】

Background: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and wellbeing of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic. Method: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. Results: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights. Limitations: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic. Conclusions: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population.

【 授权许可】

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