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Calafiore C, Collins AC, Bartoszek G, Winer ES. Assessing relinquishment of positivity as a central symptom bridging anxiety and depression. J Affect Disord 2024; 367:38-48. [PMID: 39147161 DOI: 10.1016/j.jad.2024.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/28/2024] [Accepted: 08/11/2024] [Indexed: 08/17/2024]
Abstract
Anxiety and depression are often comorbid and chronic disorders. Previous research indicates that positivity relinquishment is a moderator of anxiety and depression, such that only anxious individuals who endorsed relinquishing positivity were also depressed. We sought to extend those findings by conducting three network analyses with self-report measures of anxiety, depression, activity avoidance, and perceived positivity of avoided activities (N = 104). We pre-registered our hypothesis for the first two networks that relinquishment of positivity would emerge as a central bridge symptom between anxiety and depressive symptoms. After combining redundant nodes, we estimated three networks and investigated the bridge symptoms in each network. Relinquishment of positivity bridged the symptom clusters in the first network, and avoidance of positivity was found to bridge the two symptom clusters of anxiety and depression in networks two and three. Additionally, an anhedonia circuit was uncovered in all three networks in which loss of interest/worthlessness, loss of energy, and loss of pleasure/pessimism connected to anxiety through relinquishment or avoidance. Our findings suggest that both relinquishment of positivity as well as avoidance of positivity could be potential pathways explaining the development and maintenance of anxiety and depression and should be properly targeted in treatment.
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Affiliation(s)
- Camryn Calafiore
- Department of Psychology, The New School for Social Research, 6 E 16(th) St, New York, NY 10003, USA.
| | - Amanda C Collins
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA
| | - Gregory Bartoszek
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, NJ, USA
| | - E Samuel Winer
- Department of Psychology, The New School for Social Research, 6 E 16(th) St, New York, NY 10003, USA
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Cai H, Chen MY, Li XH, Zhang L, Su Z, Cheung T, Tang YL, Malgaroli M, Jackson T, Zhang Q, Xiang YT. A network model of depressive and anxiety symptoms: a statistical evaluation. Mol Psychiatry 2024; 29:767-781. [PMID: 38238548 PMCID: PMC11153039 DOI: 10.1038/s41380-023-02369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Although network analysis studies of psychiatric syndromes have increased in recent years, most have emphasized centrality symptoms and robust edges. Broadening the focus to include bridge symptoms within a systematic review could help to elucidate symptoms having the strongest links in network models of psychiatric syndromes. We conducted this systematic review and statistical evaluation of network analyses on depressive and anxiety symptoms to identify the most central symptoms and bridge symptoms, as well as the most robust edge indices of networks. METHODS A systematic literature search was performed in PubMed, PsycINFO, Web of Science, and EMBASE databases from their inception to May 25, 2022. To determine the most influential symptoms and connections, we analyzed centrality and bridge centrality rankings and aggregated the most robust symptom connections into a summary network. After determining the most central symptoms and bridge symptoms across network models, heterogeneity across studies was examined using linear logistic regression. RESULTS Thirty-three studies with 78,721 participants were included in this systematic review. Seventeen studies with 23 cross-sectional networks based on the Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder (GAD-7) assessments of clinical and community samples were examined using centrality scores. Twelve cross-sectional networks based on the PHQ and GAD-7 assessments were examined using bridge centrality scores. We found substantial variability between study samples and network features. 'Sad mood', 'Uncontrollable worry', and 'Worrying too much' were the most central symptoms, while 'Sad mood', 'Restlessness', and 'Motor disturbance' were the most frequent bridge centrality symptoms. In addition, the connection between 'Sleep' and 'Fatigue' was the most frequent edge for the depressive and anxiety symptoms network model. CONCLUSION Central symptoms, bridge symptoms and robust edges identified in this systematic review can be viewed as potential intervention targets. We also identified gaps in the literature and future directions for network analysis of comorbid depression and anxiety.
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Affiliation(s)
- Hong Cai
- Unit of medical psychology and behavior medicine, school of public health, Guangxi Medical University, Nanning, Guangxi, China
| | - Meng-Yi Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Atlanta VA Medical Center, Atlanta, GA, USA
| | - Matteo Malgaroli
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
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Muyiduli X, Zhang R, Zhang J, Zhe W, Dong Y, Wang W, Fang P, Zhang Y, Zhang S, Sulidan A, Rejiafu S, Sun J. Prevalence and relevant factors of depression among adolescents in Xinjiang, China: A cross-sectional survey. Medicine (Baltimore) 2024; 103:e37090. [PMID: 38363909 PMCID: PMC10869075 DOI: 10.1097/md.0000000000037090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/05/2024] [Indexed: 02/18/2024] Open
Abstract
The aim of this study is to elucidate the prevalence of depression and examine the contributing factors to depression among adolescents in Xinjiang, China. A stratified cluster sampling methodology was employed in this study, with the sample size determined through consideration of prior studies on adolescent depression. Employing this approach, 6 schools were chosen from each prefecture-level city, designated as urban areas, and 3 schools were selected from each county. Subsequently, individual classes were treated as units, and a minimum of 80 students from each grade were surveyed within the entire class. The investigation of adolescents involved the administration of a questionnaire assessing the factors influencing depression, along with the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate linear regression was used to analyze the influencing factors of depression. The occurrence rates of depression were 12.17%, 13.05%, 12.32%, and 9.29% in junior middle school, senior middle school, vocational high school, and college, respectively. The corresponding CES-D scores were 10.54 ± 8.26, 11.20 ± 8.37, 12.17 ± 6.94, and 11.33 ± 6.28. Significant associations with the CES-D score were observed for gender, smoking, alcohol consumption, and spending more than 4 hours online daily across the educational levels mentioned. The risk of experiencing depressive symptoms was elevated among female junior and senior high school students who spent more than 4 hours daily on the internet, engaged in cigarette smoking, and consumed alcohol. The findings underscore the significance of targeting high-risk groups, particularly through home-school collaborations, to mitigate excessive internet use and consequently reduce the likelihood of depressive symptoms in students.
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Affiliation(s)
- Xiamusiye Muyiduli
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Rong Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jun Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wei Zhe
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yan Dong
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Wenlei Wang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Ping Fang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Yi Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Song Zhang
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Adila Sulidan
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Shawulaxi Rejiafu
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Jingxuan Sun
- Division for Chronic and Non-communicable Disease Control and Prevention, The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
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Zhang Y, Cui Y, Li Y, Lu H, Huang H, Sui J, Guo Z, Miao D. Network analysis of depressive and anxiety symptoms in older Chinese adults with diabetes mellitus. Front Psychiatry 2024; 15:1328857. [PMID: 38347882 PMCID: PMC10859512 DOI: 10.3389/fpsyt.2024.1328857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
Background The move away from investigating mental disorders as whole using sum scores to the analysis of symptom-level interactions using network analysis has provided new insights into comorbidities. The current study explored the dynamic interactions between depressive and anxiety symptoms in older Chinese adults with diabetes mellitus (DM) and identified central and bridge symptoms in the depression-anxiety network to provide potential targets for prevention and intervention for depression and anxiety. Methods This study used a cross-sectional design with data from the 2017-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A regularized partial correlation network for depressive and anxiety symptoms was estimated based on self-reported scales completed by 1685 older adults with DM aged 65 years or older. Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the Seven-Item Generalized Anxiety Disorder Scale (GAD-7), respectively. Expected influence (EI) and bridge expected influence (BEI) indices were calculated for each symptom. Results According to cutoff scores indicating the presence of depression and anxiety, the prevalences of depression and anxiety in our sample were 52.9% and 12.8%, respectively. The comorbidity rate of depression and anxiety was 11.5%. The six edges with the strongest regularized partial correlations were between symptoms from the same disorder. "Feeling blue/depressed", "Nervousness or anxiety", "Uncontrollable worry", "Trouble relaxing", and "Worry too much" had the highest EI values. "Nervousness or anxiety" and "Everything was an effort" exhibited the highest BEI values. Conclusion Central and bridge symptoms were highlighted in this study. Targeting these symptoms may be effective in preventing the comorbidity of depressive and anxiety symptoms and facilitate interventions in older Chinese adults with DM who are at risk for or currently have depressive and anxiety symptoms.
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Affiliation(s)
- Yajuan Zhang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi’an, China
| | - Yijun Li
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Hongliang Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - He Huang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Jiaru Sui
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Danmin Miao
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
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Yoo C, Kim MJ. Topographical similarity of cortical thickness represents generalized anxiety symptoms in adolescence. Brain Res Bull 2023; 202:110728. [PMID: 37558098 DOI: 10.1016/j.brainresbull.2023.110728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/11/2023]
Abstract
Generalized anxiety disorder (GAD) is a common condition characterized by excessive and uncontrollable worry, along with its high comorbidity rates. Despite increasing efforts to identify the neural underpinnings of GAD, neuroimaging research using cortical thickness have yielded largely inconsistent results. To address this, we adopted an inter-subject representational similarity analysis framework to explore a potential nonlinear relationship between vertex-wise cortical thickness and generalized anxiety symptom severity. We utilized a sample of 120 adolescents (13-18 years of age) from the Healthy Brain Network dataset. Here, we found greater topographical resemblance among participants with heightened generalized anxiety symptoms in the left caudal anterior cingulate and pericalcarine cortex. These results were not driven by the effects of age, sex, ADHD diagnosis, and GAD diagnosis. Such associations were not observed when including a group of younger participants (11-12 years of age) for analyses, highlighting the importance of age range selection when considering the link between cortical thickness and anxiety. Our findings reveal a novel cortical thickness topography that represents generalized anxiety in adolescents, which is embedded within the shared geometries between generalized anxiety symptoms and cortical thickness.
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Affiliation(s)
- Chaebin Yoo
- Department of Psychology, Sungkyunkwan University, Seoul 03063, South Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16419, South Korea
| | - M Justin Kim
- Department of Psychology, Sungkyunkwan University, Seoul 03063, South Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16419, South Korea.
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Kooiman BEAM, Robberegt SJ, Albers CJ, Bockting CLH, Stikkelbroek YAJ, Nauta MH. Congruency of multimodal data-driven personalization with shared decision-making for StayFine: individualized app-based relapse prevention for anxiety and depression in young people. Front Psychiatry 2023; 14:1229713. [PMID: 37840790 PMCID: PMC10570515 DOI: 10.3389/fpsyt.2023.1229713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023] Open
Abstract
Tailoring interventions to the individual has been hypothesized to improve treatment efficacy. Personalization of target-specific underlying mechanisms might improve treatment effects as well as adherence. Data-driven personalization of treatment, however, is still in its infancy, especially concerning the integration of multiple sources of data-driven advice with shared decision-making. This study describes an innovative type of data-driven personalization in the context of StayFine, a guided app-based relapse prevention intervention for 13- to 21-year-olds in remission of anxiety or depressive disorders (n = 74). Participants receive six modules, of which three are chosen from five optional modules. Optional modules are Enhancing Positive Affect, Behavioral Activation, Exposure, Sleep, and Wellness. All participants receive Psycho-Education, Cognitive Restructuring, and a Relapse Prevention Plan. The personalization approach is based on four sources: (1) prior diagnoses (diagnostic interview), (2) transdiagnostic psychological factors (online self-report questionnaires), (3) individual symptom networks (ecological momentary assessment, based on a two-week diary with six time points per day), and subsequently, (4) patient preference based on shared decision-making with a trained expert by experience. This study details and evaluates this innovative type of personalization approach, comparing the congruency of advised modules between the data-driven sources (1-3) with one another and with the chosen modules during the shared decision-making process (4). The results show that sources of data-driven personalization provide complementary advice rather than a confirmatory one. The indications of the modules Exposure and Behavioral Activation were mostly based on the diagnostic interview, Sleep on the questionnaires, and Enhancing Positive Affect on the network model. Shared decision-making showed a preference for modules improving positive concepts rather than combating negative ones, as an addition to the data-driven advice. Future studies need to test whether treatment outcomes and dropout rates are improved through personalization.
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Affiliation(s)
- Bas E. A. M. Kooiman
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
- Depression Expertise Centre-Youth, GGZ Oost Brabant, Boekel, Netherlands
| | - Suzanne J. Robberegt
- Depression Expertise Centre-Youth, GGZ Oost Brabant, Boekel, Netherlands
- Department of Psychiatry, Amsterdam University Medical Centres–Location AMC, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Casper J. Albers
- Department of Psychometrics and Statistics, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Claudi L. H. Bockting
- Department of Psychiatry, Amsterdam University Medical Centres–Location AMC, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Yvonne A. J. Stikkelbroek
- Depression Expertise Centre-Youth, GGZ Oost Brabant, Boekel, Netherlands
- Department of Clinical Child and Family Studies, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | - Maaike H. Nauta
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
- Accare Child Study Centre, Groningen, Netherlands
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Liu ZH, Li Y, Tian ZR, Zhao YJ, Cheung T, Su Z, Chen P, Ng CH, An FR, Xiang YT. Prevalence, correlates, and network analysis of depression and its associated quality of life among ophthalmology nurses during the COVID-19 pandemic. Front Psychol 2023; 14:1218747. [PMID: 37691783 PMCID: PMC10484007 DOI: 10.3389/fpsyg.2023.1218747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/24/2023] [Indexed: 09/12/2023] Open
Abstract
Background Nurses in Ophthalmology Department (OD) had a high risk of infection during the novel coronavirus disease 2019 (COVID-19) pandemic. This study examined the prevalence, correlates, and network structure of depression, and explored its association with quality of life (QOL) in Chinese OD nurses. Methods Based on a cross-sectional survey, demographic and clinical data were collected. Depression was measured with the 9-item Self-reported Patient Health Questionnaire (PHQ-9), and QOL was measured using the World Health Organization Quality of Life Questionnaire-brief version (WHOQOL-BREF). Univariate analyses, multivariate logistic regression analyses, and network analyses were performed. Results Altogether, 2,155 OD nurses were included. The overall prevalence of depression among OD nurses was 32.71% (95%CI: 30.73-34.70%). Multiple logistic regression analysis revealed that having family or friends or colleagues who were infected (OR = 1.760, p = 0.003) was significantly associated with higher risk of depression. After controlling for covariates, nurses with depression reported lower QOL (F(1, 2,155) = 596.784, p < 0.001) than those without depression. Network analyses revealed that 'Sad Mood', 'Energy Loss' and 'Worthlessness' were the key central symptoms. Conclusion Depression was common among OD nurses during the COVID-19 pandemic. Considering the negative impact of depression on QOL and daily life, regular screening for depression, timely counselling service, and psychiatric treatment should be provided for OD nurses, especially those who had infected family/friends or colleagues. Central symptoms identified in network analysis should be targeted in the treatment of depression.
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Affiliation(s)
- Zi-Han Liu
- Department of Psychiatry, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong, China
| | - Yue Li
- Department of Nursing, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zi-Rong Tian
- Department of Nursing, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan-Jie Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
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Warner EN, Ammerman RT, Glauser TA, Pestian JP, Agasthya G, Strawn JR. Developmental Epidemiology of Pediatric Anxiety Disorders. Child Adolesc Psychiatr Clin N Am 2023; 32:511-530. [PMID: 37201964 DOI: 10.1016/j.chc.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This review summarizes the developmental epidemiology of childhood and adolescent anxiety disorders. It discusses the coronavirus disease of 2019 (COVID-19) pandemic, sex differences, longitudinal course, and stability of anxiety disorders in addition to recurrence and remission. The trajectory of anxiety disorders-whether homotypic (ie, the same anxiety disorder persists over time) or heterotypic (ie, an anxiety disorder shifts to a different diagnosis over time) is discussed with regard to social, generalized, and separation anxiety disorders as well as specific phobia, and panic disorder. Finally, strategies for early recognition, prevention, and treatment of disorders are discussed.
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Affiliation(s)
- Emily N Warner
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Environmental and Public Health Sciences, University of Cincinnati.
| | - Robert T Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Tracy A Glauser
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - John P Pestian
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Greeshma Agasthya
- Oak Ridge National Laboratory, Computational Sciences and Engineering Division, Advanced Computing for Health Sciences Section
| | - Jeffrey R Strawn
- University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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9
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Chen X, Ren L, Xue X, Yu N, Liu P, Shen W, Zhou H, Wang B, Zhou J, Yang S, Jiang Q. The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis. Brain Sci 2023; 13:brainsci13040583. [PMID: 37190548 DOI: 10.3390/brainsci13040583] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Sufferers of tinnitus, especially of the prolonged type, frequently suffer from comorbid depression and anxiety. From the perspective of the network model, this comorbidity is thought to be an interacting system of these two symptoms. In our study, we conducted a network analysis of depression and anxiety comorbidity in tinnitus sufferers, aiming to identify the central and bridge symptoms and make informed suggestions for clinical interventions and psychotherapy. METHOD A total of 566 tinnitus sufferers were enrolled in our study. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder 7-Item Questionnaire (GAD-7) were selected to evaluate depression and anxiety symptoms, respectively, followed by network analysis to construct the interacting networks. RESULTS The findings identified six edges of strongest regularized partial correlations in this network. Of these, three were depression symptoms and three were anxiety symptoms. The anxiety symptoms "Unable to control worry" and "Relaxation difficulty" and the depression symptom "Feeling depressed or hopeless" had the highest expected influence centrality. The analysis results also revealed three bridge symptoms: "Afraid something awful might happen", "Feeling of worthlessness", and "Trouble concentrating". As for "Suicidal ideation", the direct relations between this symptom and "Afraid something awful might happen" and "Feeling depressed or hopeless" were the strongest. CONCLUSIONS The central and bridge symptoms of the interacting network of depression and anxiety symptoms in tinnitus sufferers can be considered a significant transdiagnostic intervention target for the management of this comorbidity. In particular, clinical prevention and psychotherapy should be implemented, targeting the symptoms that have the strongest associations with suicidal ideation.
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Affiliation(s)
- Xuemin Chen
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Xinmiao Xue
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Ning Yu
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - Peng Liu
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Weidong Shen
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - Hanwen Zhou
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Ben Wang
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Jingcheng Zhou
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Shiming Yang
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - Qingqing Jiang
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
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Wu L, Sun L, Wang J, Sun Y, Zhang X, Huang Y, Lu Y, Cao F. Psychological distress among women undergoing in vitro fertilization-embryo transfer: A cross-sectional and longitudinal network analysis. Front Psychol 2023; 13:1095365. [PMID: 36687877 PMCID: PMC9849569 DOI: 10.3389/fpsyg.2022.1095365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Background Women undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment were generally found to experience varying degrees of psychological distress across the treatment. Existing studies focused on total scores and diagnostic thresholds to characterize the symptoms' severity, which might hinder scientific progress in understanding and treating psychological distress. Aims We aimed to investigate (a) how depression and anxiety symptoms are interconnected within a network, and (b) the changes of the network (symptom connections and network centralities) over time, in women undergoing in vitro fertilization-embryo transfer. Methods A 4-wave longitudinal study was designed with 343 eligible women recruited from the Reproductive Medicine Center of a tertiary hospital in China. The network models were created to explore the relationship and changes between psychopathology symptoms both within and across anxiety and depression, with anxiety measured by the Generalized Anxiety Disorder-7 and depression measured by the Patient Health Questionnaire-9. Symptom network analysis was conducted to evaluate network and network properties, network centrality, and bridge centrality, as well as change trajectory network. Results For the strength centrality, "inability to control worry" and "worrying too much" were the most central symptoms at T1; however, these symptoms decreased. The centrality of "sadness" and "guilt" tended to increase steadily and became dominant symptoms. For bridge centrality indices, several bridge symptoms were identified separately from T1 to T4: "irritability," "concentration difficulties," "nervousness," and "restlessness;" "guilt" exhibited increased bridge symptoms. Furthermore, the change trajectory network indicated that "suicide ideation" became more closely related to guilt but not to worrying too much over time. Conclusion This study provides novel insights into the changes in central features, connections, and bridge symptoms during IVF-ET treatment and identified several bridge symptoms separately at different stages, which could activate the connection between psychopathology symptoms. The results revealed that sense of guilt was associated with worsening psychopathology symptoms, indicating that future psychological interventions should target guilt-related symptoms as a priority.
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Affiliation(s)
- Liuliu Wu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lijing Sun
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Juan Wang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yaoyao Sun
- Institute of Mental Health, Peking University Sixth Hospital, Beijing, China
| | - Xuan Zhang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yongqi Huang
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yan’e Lu
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fenglin Cao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China,*Correspondence: Fenglin Cao, ✉
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11
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Yang T, Guo Z, Cao X, Zhu X, Zhou Q, Li X, Wang H, Wang X, Wu L, Wu S, Liu X. Network analysis of anxiety and depression in the functionally impaired elderly. Front Public Health 2022; 10:1067646. [PMID: 36530716 PMCID: PMC9751796 DOI: 10.3389/fpubh.2022.1067646] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Background Evidence from previous studies has confirmed that functionally impaired elderly individuals are susceptible to comorbid anxiety and depression. Network theory holds that the comorbidity emerges from interactions between anxiety and depression symptoms. This study aimed to investigate the fine-grained relationships among anxiety and depression symptoms in the functionally impaired elderly and identify central and bridge symptoms to provide potential targets for intervention of these two comorbid disorders. Methods A total of 325 functionally impaired elderly individuals from five communities in Xi'an, China, were recruited for our investigation. The GAD-7 and PHQ-9 were used to measure anxiety and depression, respectively. SPSS 22.0 software was used for descriptive statistics, and R 4.1.1 software was used for network model construction, expected influence (EI) evaluation and bridge expected influence (BEI) evaluation. Results In the network, there were 35 edges (indicating partial correlations between symptoms) across the communities of anxiety and depression, among which the strongest edge was A1 "Nervousness or anxiety"-D2 "Depressed or sad mood." A2 "Uncontrollable worry" and D2 "Depressed or sad mood" had the highest EI values in the network, while A6 "Irritable" and D7 "Concentration difficulties" had the highest BEI values of their respective community. In the flow network, the strongest direct edge of D9 "Thoughts of death" was with D6 "Feeling of worthlessness." Conclusion Complex fine-grained relationships exist between anxiety and depression in functionally impaired elderly individuals. "Uncontrollable worry," "depressed or sad mood," "irritable" and "concentration difficulties" are identified as the potential targets for intervention of anxiety and depression. Our study emphasizes the necessity of suicide prevention for functionally impaired elderly individuals, and the symptom "feeling of worthlessness" can be used as an effective target.
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Affiliation(s)
- Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiaoqin Cao
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Qin Zhou
- Xijing Hospital, Air Force Medical University, Shaanxi, China
| | - Xinhong Li
- Tangdu Hospital, Air Force Medical University, Shaanxi, China
| | - Hui Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Xiuchao Wang
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Lin Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China
| | - Shengjun Wu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,Shengjun Wu
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Shaanxi, China,*Correspondence: Xufeng Liu
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12
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Dahchour A. Anxiolytic and antidepressive potentials of rosmarinic acid: A review with a focus on antioxidant and anti-inflammatory effects. Pharmacol Res 2022; 184:106421. [PMID: 36096427 DOI: 10.1016/j.phrs.2022.106421] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
Abstract
Depression and anxiety are the most prevalent neuropsychiatric disorders that have emerged as global health concerns. Anxiolytic and antidepressant drugs, such as benzodiazepines, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and tricyclics, are the first line used in treating anxiety and depression. Although these drugs lack efficacy and have a delayed response time and numerous side effects, their widespread abuse and market continue to grow. Over time, traditional practices using natural and phytochemicals as alternative therapies to chemical drugs have emerged to treat many pathological conditions, including anxiety and depression. Recent preclinical studies have demonstrated that the phenolic compound, rosmarinic acid, is effective against several neuropsychiatric disorders, including anxiety and depression. In addition, rosmarinic acid showed various pharmacological effects, such as cardioprotective, hepatoprotective, lung protective, antioxidant, anti-inflammatory, and neuroprotective effects. However, the potentialities of the use of rosmarinic acid in the treatment of nervous system-related disorders, such as anxiety and depression, are less or not yet reviewed. Therefore, the purpose of this review was to present several preclinical and clinical studies, when available, from different databases investigating the effects of rosmarinic acid on anxiety and depression. These studies showed that rosmarinic acid produces advantageous effects on anxiety and depression through its powerful antioxidant and anti-inflammatory properties. This review will examine and discuss the possibility that the anxiolytic and anti-depressive effects of rosmarinic acid could be associated with its potent antioxidant and anti-inflammatory activities.
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Affiliation(s)
- Abdelkader Dahchour
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy. Department of Biology, Faculty of Sciences, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco.
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13
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Baumel WT, Mills JA, Schroeder HK, Specht AM, Rothenberg R, Peris TS, Strawn JR. Executive Functioning in Pediatric Anxiety and Its Relationship to Selective Serotonin Reuptake Inhibitor Treatment Response: A Double-Blind, Placebo-Controlled Trial. J Child Adolesc Psychopharmacol 2022; 32:215-223. [PMID: 35532982 PMCID: PMC9145261 DOI: 10.1089/cap.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To characterize executive function in adolescents with generalized anxiety disorder (GAD) and its relationship to treatment. Methods: Using data from a double-blind, placebo-controlled trial of escitalopram in adolescents (N = 51) 12-17 years of age with GAD, we used the self-report version of the Behavior Rating Inventory of Executive Function (BRIEF-SR) to assess executive function, at baseline, and examined its relationship to treatment response as measured by the Pediatric Anxiety Rating Scale (PARS). Results: For all baseline subscores of the BRIEF-SR, T-scores were significantly elevated in adolescents with GAD compared to an age- and sex-matched normative healthy sample. In escitalopram-treated patients, baseline BRIEF-SR scores for Emotional Control (β = 0.256, 95% credibility interval [CrI]: 0.367 to 0.146, p < 0.001), Working Memory (β = 0.204, CrI: 0.2952 to 0.1134, p < 0.001), Planning/Organizing (β = -0.223, CrI: -0.1021 to -0.3436, p = 0.004), and Task Completion (β = -0.152, CrI: 0.075 to 0.228, p = 0.002) predicted the trajectory of improvement in PARS score over the 8-week trial. For youth who received placebo, only the Inhibit score was significantly, but weakly, associated with response trajectory (β = -0.081, CrI: -0.0167 to -0.1461, p = 0.015). For adolescents who had clinically significant impairment in Emotional Control, Working Memory, Planning/Organizing, and Task Completion (i.e., T-score >65), the trajectory of improvement significantly differed from patients without scores in the clinically significant range. Conclusions: Taken together, these findings point to the potential value of assessing executive function in youth with anxiety disorders as one strategy for guiding treatment selection. These data suggest that executive function may predict treatment response to psychopharmacologic treatment and point to numerous avenues for further personalizing treatment.
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Affiliation(s)
- W. Thomas Baumel
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jeffrey A. Mills
- Department of Economics, Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA
| | - Heidi K. Schroeder
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ashley M. Specht
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Richard Rothenberg
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Tara S. Peris
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Jeffrey R. Strawn
- Department of Psychiatry and Behavioral Neuroscience, Anxiety Disorders Research Program, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Division of Child and Adolescent Psychiatry, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Clinical Pharmacology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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14
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Grassie HL, Kennedy SM, Halliday ER, Bainter SA, Ehrenreich-May J. Symptom-level networks of youth- and parent-reported depression and anxiety in a transdiagnostic clinical sample. Depress Anxiety 2022; 39:211-219. [PMID: 35072967 DOI: 10.1002/da.23241] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/19/2021] [Accepted: 01/08/2022] [Indexed: 11/09/2022] Open
Abstract
Depression and anxiety disorders confer a significant public health concern for youth and their co-occurrence places youth at a higher risk for poorer psychosocial outcomes. In the present study, we use network analysis to investigate the role of and interactions among individual depression and anxiety symptoms in a treatment-seeking clinical sample. METHODS We estimate regularized partial correlation networks for youth- and parent reported symptoms in a transdiagnostic sample of youth (N = 417, ages 8-18). We examined features of the symptom-level networks such as network stability, centrality, bridge symptoms, and communities in both youth- and parent-reported networks. RESULTS Results indicate stable networks with disorder-specific clustering, such that symptoms were more interconnected within compared to between disorders. Symptoms related to self-comparison to peers and negative views of the future were most central in both networks. Symptoms of depression and anxiety were connected by worries for the future and hopelessness in the youth-reported network, whereas self-comparison to peers and low self-efficacy were bridge symptoms in the parent network. Distinct symptom clusters emerged in the parent- and youth-reported networks. CONCLUSIONS Our findings indicate that negative self-evaluation, negative views of the future, and repetitive negative thinking more generally are influential symptoms in the presentation and co-occurrence of depression and anxiety and as such may be promising targets in the treatment and prevention of depression and anxiety in youth.
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Affiliation(s)
- Hannah L Grassie
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sarah M Kennedy
- Department of Psychiatry, Medical Campus, University of Colorado Anschutz, Aurora, Colorado, USA
| | | | - Sierra A Bainter
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
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15
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Marqués-Sánchez P, Pinto-Carral A, Fernández-Villa T, Vázquez-Casares A, Liébana-Presa C, Benítez-Andrades JA. Identification of cohesive subgroups in a university hall of residence during the COVID-19 pandemic using a social network analysis approach. Sci Rep 2021; 11:22055. [PMID: 34764333 PMCID: PMC8586037 DOI: 10.1038/s41598-021-01390-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/22/2021] [Indexed: 11/29/2022] Open
Abstract
THE AIMS (i) analyze connectivity between subgroups of university students, (ii) assess which bridges of relational contacts are essential for connecting or disconnecting subgroups and (iii) to explore the similarities between the attributes of the subgroup nodes in relation to the pandemic context. During the COVID-19 pandemic, young university students have experienced significant changes in their relationships, especially in the halls of residence. Previous research has shown the importance of relationship structure in contagion processes. However, there is a lack of studies in the university setting, where students live closely together. The case study methodology was applied to carry out a descriptive study. The participation consisted of 43 university students living in the same hall of residence. Social network analysis has been applied for data analysis. Factions and Girvan-Newman algorithms have been applied to detect the existing cohesive subgroups. The UCINET tool was used for the calculation of the SNA measure. A visualization of the global network will be carried out using Gephi software. After applying the Girvan-Newman and Factions, in both cases it was found that the best division into subgroups was the one that divided the network into 4 subgroups. There is high degree of cohesion within the subgroups and a low cohesion between them. The relationship between subgroup membership and gender was significant. The degree of COVID-19 infection is related to the degree of clustering between the students. College students form subgroups in their residence. Social network analysis facilitates an understanding of structural behavior during the pandemic. The study provides evidence on the importance of gender, race and the building where they live in creating network structures that favor, or not, contagion during a pandemic.
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Affiliation(s)
- Pilar Marqués-Sánchez
- SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Campus de Ponferrada s/n, 24400, Ponferrada, Spain
| | - Arrate Pinto-Carral
- SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Campus de Ponferrada s/n, 24400, Ponferrada, Spain.
| | - Tania Fernández-Villa
- The Research Group in Gen-Environment and Health Interactions (GIIGAS), Institute of Biomedicine (IBIOMED), Universidad de León, 24071, León, Spain
| | - Ana Vázquez-Casares
- Department of Nursing and Physiotherapy, Universidad de León, Campus de Vegazana s/n, 24071, León, Spain
| | - Cristina Liébana-Presa
- SALBIS Research Group, Department of Nursing and Physiotherapy, Universidad de León, Campus de Ponferrada s/n, 24400, Ponferrada, Spain
| | - José Alberto Benítez-Andrades
- SALBIS Research Group, Department of Electric, Systems and Automatics Engineering, Universidad de León, Campus of Vegazana s/n, 24071, León, Spain
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16
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Bai W, Zhao Y, An F, Zhang Q, Sha S, Cheung T, Cheng CPW, Ng CH, Xiang YT. Network Analysis of Insomnia in Chinese Mental Health Professionals During the COVID-19 Pandemic: A Cross-Sectional Study. Nat Sci Sleep 2021; 13:1921-1930. [PMID: 34737660 PMCID: PMC8560171 DOI: 10.2147/nss.s326880] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/16/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic is associated with increased risk of insomnia symptoms (insomnia hereafter) in health-care professionals. Network analysis is a novel approach in linking mechanisms at the symptom level. The aim of this study was to characterize the insomnia network structure in mental health professionals during the COVID-19 pandemic. PATIENTS AND METHODS A total of 10,516 mental health professionals were recruited from psychiatric hospitals or psychiatric units of general hospitals nationwide between March 15 and March 20, 2020. Insomnia was assessed with the insomnia severity index (ISI). Centrality index (ie, strength) was used to identify symptoms central to the network. The stability of network was examined using a case-dropping bootstrap procedure. The network structures between different genders were also compared. RESULTS The overall network model showed that the item ISI7 (interference with daytime functioning) was the most central symptom in mental health professionals with the highest strength. The network was robust in stability and accuracy tests. The item ISI4 (sleep dissatisfaction) was connected to the two main clusters of insomnia symptoms (ie, the cluster of nocturnal and daytime symptoms). No significant gender network difference was found. CONCLUSION Interference with daytime functioning was the most central symptom, suggesting that it may be an important treatment outcome measure for insomnia. Appropriate treatments, such as stimulus control techniques, cognitive behavioral therapy and relaxation training, could be developed. Moreover, addressing sleep satisfaction in treatment could simultaneously ameliorate daytime and nocturnal symptoms.
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Affiliation(s)
- Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, People’s Republic of China
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, People’s Republic of China
| | - Yanjie Zhao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, People’s Republic of China
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, People’s Republic of China
| | - Fengrong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, People’s Republic of China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, People’s Republic of China
| | - Calvin Pak-Wing Cheng
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, People’s Republic of China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, People’s Republic of China
- Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, People’s Republic of China
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17
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Li Y, Chu T, Che K, Dong F, Shi Y, Ma H, Zhao F, Mao N, Xie H. Altered gray matter structural covariance networks in postpartum depression: a graph theoretical analysis. J Affect Disord 2021; 293:159-167. [PMID: 34192630 DOI: 10.1016/j.jad.2021.05.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is a serious postpartum mental health problem worldwide. To date, minimal is known about the alteration of topographical organization in the brain structural covariance network of patients with PPD. This study investigates the brain structural covariance networks of patients with PPD by using graph theoretical analysis. METHODS High-resolution 3D T1 structural images were acquired from 21 drug-naive patients with PPD and 18 healthy postpartum women. Cortical thickness was extracted from 64 brain regions to construct the whole-brain structural covariance networks by calculating the Pearson correlation coefficients, and their topological properties (e.g., small-worldness, efficiency, and nodal centrality) were analyzed by using graph theory. Nonparametric permutation tests were further used for group comparisons of topological metrics. A node was set as a hub if its betweenness centrality (BC) was at least two standard deviations higher than the mean nodal centrality. Network-based statistic (NBS) was used to determine the connected subnetwork. RESULTS The PPD and control groups showed small-worldness of group networks, but the small-world network was more evidently in the PPD group. Moreover, the PPD group showed increased network local efficiency and almost similar network global efficiency. However, the difference of the network metrics was not significant across the range of network densities. The hub nodes of the patients with PPD were right inferior parietal lobule (BC = 13.69) and right supramarginal gyrus (BC = 13.15), whereas those for the HCs were left cuneus (BC = 14.96), right caudal anterior-cingulate cortex (BC = 15.51), and right precuneus gyrus (BC = 15.74). NBS demonstrated two disrupted subnetworks that are present in PPD: the first subnetwork with decreased internodal connections is mainly involved in the cognitive-control network and visual network, and the second subnetwork with increased internodal connections is mainly involved in the default mode network, cognitive-control network and visual network. CONCLUSIONS This study demonstrates the alteration of topographical organization in the brain structural covariance network of patients with PPD, providing in sight on the notion that PPD could be characterized as a systems-level disorder.
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Affiliation(s)
- Yuna Li
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Tongpeng Chu
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Kaili Che
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Fanghui Dong
- School of Medical Imaging, Binzhou Medical University, Yantai, Shandong 264000, P.R. China
| | - Yinghong Shi
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Heng Ma
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Feng Zhao
- Compute Science and Technology, Shandong Technology and Business University Yantai, Shandong 264000, P.R. China
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China.
| | - Haizhu Xie
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong 264000, P.R. China.
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