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Li Z, Peng P, Yan K, Wang X, Zhang X, Xu H, Li X, Wu M, Li P, Deng Q, Liu T, Tang YY, Wu Q. Perceived helplessness is the central symptom of mental distress in Chinese physicians: Network analysis and replication of stress, burnout, depression, and anxiety. Asian J Psychiatr 2024; 102:104247. [PMID: 39303332 DOI: 10.1016/j.ajp.2024.104247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 09/15/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024]
Affiliation(s)
- Zejun Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Pu Peng
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310016, China
| | - Kewen Yan
- Department of Psychiatry, The Third People's Hospital of Qujing, Qujing, Yunnan 655000, China
| | - Xin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xiaoyu Zhang
- Department of Psychiatry, The Third People's Hospital of Qujing, Qujing, Yunnan 655000, China
| | - Huixue Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xueyi Li
- Department of Psychiatry, The Third People's Hospital of Qujing, Qujing, Yunnan 655000, China
| | - Min Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Peizhen Li
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Qijian Deng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA.
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, the Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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Zhang C, Zhao Y, Wei L, Tang Q, Deng R, Yan S, Yao J. Depression and Anxiety among Migrant Older Adults during the COVID-19 Pandemic in China: Network Analysis of Continuous Cross-Sectional Data. Healthcare (Basel) 2024; 12:1802. [PMID: 39337142 PMCID: PMC11431247 DOI: 10.3390/healthcare12181802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/18/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Many Chinese migrant older adults are more prone to mental health problems due to their "migrant" status. During the COVID-19 pandemic, restrictions on their mobility exacerbated these conditions. Mental health is a crucial dimension of healthy aging. Network analysis offers a novel method for exploring interactions between mental health problems at the symptom level. This study employs network analysis to examine the interactions between comorbid depressive and anxiety symptoms across different stages of the COVID-19 pandemic. Surveys were conducted from September 2019 to January 2020 (T1), September 2020 to January 2021 (T2), and September 2021 onwards (T3). Depression and anxiety symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Expected Influence (EI) and Bridge Expected Influence (Bridge EI) were used to identify central and bridge symptoms in the network. Network stability and accuracy tests were performed. Among the Chinese migrant older adults, the anxiety prevalence was 18.50% at T1, 21.11% at T2, and 9.38% at T3. The prevalence of depression was 26.95% at T1, 55.44% at T2, and 60.24% at T3. The primary central symptoms included 'Afraid something will happen' (A2), 'Irritability' (A6), 'Panic' (A7), 'Feeling of worthlessness' (D6), 'Anhedonia' (D1), and 'Feeling of fear' (A5). The major bridge symptoms included 'Feeling of fear' (A5), 'Panic' (A7), 'Irritability' (A6), 'Fatigue' (D4), 'Anhedonia' (D1), and 'Depressed or sad mood' (D2). Differences in network structure were observed across the periods. The network analysis further revealed the evolving relationships between central and bridge symptoms over time, highlighting the importance of targeted intervention strategies for central and bridge symptoms of comorbid depression and anxiety at different periods.
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Affiliation(s)
- Chi Zhang
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
| | - Yuefan Zhao
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
| | - Lei Wei
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
| | - Qian Tang
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Ruyue Deng
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
| | - Shiyuan Yan
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
| | - Jun Yao
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
- Jiangsu Provincial Institute of Health, Nanjing Medical University, Nanjing 211166, China
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Gessner J, Schulz JO, Melzig CA, Benke C. Role of interoceptive fear and maladaptive attention and behaviors in the escalation of psychopathology-a network analysis. Cogn Behav Ther 2024; 53:524-543. [PMID: 38593025 DOI: 10.1080/16506073.2024.2336036] [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: 12/11/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
The complex interplay of fear, attention, and behavior toward bodily sensations with psychopathological symptoms and how they mutually influence and potentially reinforce one another remains to be fully elucidated. In this study, we used a network analytical approach to unravel these complex interactions. Specifically, we aimed to identify central symptoms and etiologically relevant factors that might be associated with anxiety and depressive core symptoms. To this end, the following clusters were assessed in 791 adults: interoceptive fear, interoceptive attention, maladaptive behaviors related to bodily sensations, and core symptoms of anxiety and depression. This network was modeled using a Gaussian Graphical Model. Central variables (nodes) were identified using centrality indices and bridge analysis. Self-examination and attention to bodily sensations emerged as central nodes. Moreover, time spent paying attention to bodily sensations, fear of anxiety-related sensations, and self-examination were identified as central bridge nodes, that is, central nodes connecting psychopathologically relevant symptom clusters. The present study indicates that fear of bodily sensations, the amount of attention and time spent focusing on somatic sensations, and self-examination are central factors. The findings suggest potential targets for future longitudinal studies on the impact of these factors for the escalation of anxiety and depressive symptoms.
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Affiliation(s)
- Jana Gessner
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Jan-Ole Schulz
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Christiane A Melzig
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, CMBB, Philipps University Marburg and Justus Liebig University Giessen, Gießen, Germany
| | - Christoph Benke
- Department of Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
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Yang XJ, Meng XX, Zhang LB, Wang LL, Deng H, Yang YC, Zhou SJ. Mediating effects of insomnia and resilience on COVID-19-related post-traumatic stress disorder and quality of life in adolescents. Sci Rep 2024; 14:17969. [PMID: 39095413 PMCID: PMC11297128 DOI: 10.1038/s41598-024-69093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/31/2024] [Indexed: 08/04/2024] Open
Abstract
The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12-18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events.
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Affiliation(s)
- Xing-Jie Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Xue-Xue Meng
- School of Psychology and Mental Health, North China University of Science and Technology, Hebei, China
| | - Li-Bin Zhang
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Lei-Lei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Hu Deng
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Yu-Chun Yang
- Faculty of Education, Beijing Normal University, Beijing, 100875, China.
| | - Shuang-Jiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China.
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Sun HL, Chen P, Bai W, Zhang L, Feng Y, Su Z, Cheung T, Ungvari GS, Cui XL, Ng CH, An FR, Xiang YT. Prevalence and network structure of depression, insomnia and suicidality among mental health professionals who recovered from COVID-19: a national survey in China. Transl Psychiatry 2024; 14:227. [PMID: 38816419 PMCID: PMC11139988 DOI: 10.1038/s41398-024-02918-8] [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] [Received: 09/13/2023] [Revised: 02/16/2024] [Accepted: 05/07/2024] [Indexed: 06/01/2024] Open
Abstract
Psychiatric syndromes are common following recovery from Coronavirus Disease 2019 (COVID-19) infection. This study investigated the prevalence and the network structure of depression, insomnia, and suicidality among mental health professionals (MHPs) who recovered from COVID-19. Depression and insomnia were assessed with the Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index questionnaire (ISI7) respectively. Suicidality items comprising suicidal ideation, suicidal plan and suicidal attempt were evaluated with binary response (no/yes) items. Network analyses with Ising model were conducted to identify the central symptoms of the network and their links to suicidality. A total of 9858 COVID-19 survivors were enrolled in a survey of MHPs. The prevalence of depression and insomnia were 47.10% (95% confidence interval (CI) = 46.09-48.06%) and 36.2% (95%CI = 35.35-37.21%), respectively, while the overall prevalence of suicidality was 7.8% (95%CI = 7.31-8.37%). The key central nodes included "Distress caused by the sleep difficulties" (ISI7) (EI = 1.34), "Interference with daytime functioning" (ISI5) (EI = 1.08), and "Sleep dissatisfaction" (ISI4) (EI = 0.74). "Fatigue" (PHQ4) (Bridge EI = 1.98), "Distress caused by sleep difficulties" (ISI7) (Bridge EI = 1.71), and "Motor Disturbances" (PHQ8) (Bridge EI = 1.67) were important bridge symptoms. The flow network indicated that the edge between the nodes of "Suicidality" (SU) and "Guilt" (PHQ6) showed the strongest connection (Edge Weight= 1.17, followed by "Suicidality" (SU) - "Sad mood" (PHQ2) (Edge Weight = 0.68)). The network analysis results suggest that insomnia symptoms play a critical role in the activation of the insomnia-depression-suicidality network model of COVID-19 survivors, while suicidality is more susceptible to the influence of depressive symptoms. These findings may have implications for developing prevention and intervention strategies for mental health conditions following recovery from COVID-19.
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Affiliation(s)
- He-Li Sun
- 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
| | - Pan 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
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 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
| | - Yuan Feng
- 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
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Xi-Ling Cui
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong, Hong Kong 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
- 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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Chen MY, Chen P, An FR, Sha S, Feng Y, Su Z, Cheung T, Ungvari GS, Ng CH, Zhang L, Xiang YT. Depression, anxiety and suicidality among Chinese mental health professionals immediately after China's dynamic zero-COVID policy: A network perspective. J Affect Disord 2024; 352:153-162. [PMID: 38316260 DOI: 10.1016/j.jad.2024.01.270] [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: 05/12/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Using network analysis, the interactions between mental health problems at the symptom level can be explored in depth. This study examined the network structure of depressive and anxiety symptoms and suicidality among mental health professionals after the end of China's Dynamic Zero-COVID Policy. METHODS A total of 10,647 mental health professionals were recruited nationwide from January to February 2023. Depression and anxiety were assessed using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively, while suicidality was defined by a 'yes' response to any of the standard questions regarding suicidal ideation (SI), suicide plan (SP) and suicide attempt (SA). Expected Influence (EI) and Bridge Expected Influence (bEI) were used as centrality indices in the symptom network to characterize the structure of the symptoms. RESULTS The prevalence of depression, anxiety, and suicidality were 45.99 %, 28.40 %, and 7.71 %, respectively. The network analysis identified GAD5 ("Restlessness") as the most central symptom, followed by PHQ4 ("Fatigue") and GAD7 ("Feeling afraid"). Additionally, PHQ6 ("Guilt"), GAD5 ("Restlessness"), and PHQ8 ("Motor disturbance") were bridge nodes linking depressive and anxiety symptoms with suicidality. The flow network indicated that the strongest connections of S ("Suicidality") was with PHQ6 ("Guilt"), GAD7 ("Feeling afraid"), and PHQ2 ("Sad mood"). CONCLUSIONS Depression, anxiety, and suicidality among mental health professionals were highly prevalent after China's Dynamic Zero-COVID Policy ended. Effective measures should target central and bridge symptoms identified in this network model to address the mental health problems in those at-risk.
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Affiliation(s)
- 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
| | - Pan 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
| | - Feng-Rong An
- 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
| | - Sha Sha
- 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
| | - Yuan Feng
- 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
| | - Gabor S Ungvari
- Psychiatry Section, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - 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.
| | - 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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Ramos-Vera C, García O'Diana A, Basauri-Delgado M, Calizaya-Milla YE, Saintila J. Network analysis of anxiety and depressive symptoms during the COVID-19 pandemic in older adults in the United Kingdom. Sci Rep 2024; 14:7741. [PMID: 38565592 PMCID: PMC10987576 DOI: 10.1038/s41598-024-58256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/27/2024] [Indexed: 04/04/2024] Open
Abstract
The health crisis caused by COVID-19 in the United Kingdom and the confinement measures that were subsequently implemented had unprecedented effects on the mental health of older adults, leading to the emergence and exacerbation of different comorbid symptoms including depression and anxiety. This study examined and compared depression and anxiety symptom networks in two specific quarantine periods (June-July and November-December) in the older adult population in the United Kingdom. We used the database of the English Longitudinal Study of Aging COVID-19 Substudy, consisting of 5797 participants in the first stage (54% women) and 6512 participants in the second stage (56% women), all over 50 years of age. The symptoms with the highest centrality in both times were: "Nervousness (A1)" and "Inability to relax (A4)" in expected influence and predictability, and "depressed mood (D1"; bridging expected influence). The latter measure along with "Irritability (A6)" overlapped in both depression and anxiety clusters in both networks. In addition, a the cross-lagged panel network model was examined in which a more significant influence on the direction of the symptom "Nervousness (A1)" by the depressive symptoms of "Anhedonia (D6)", "Hopelessness (D7)", and "Sleep problems (D3)" was observed; the latter measure has the highest predictive capability of the network. The results report which symptoms had a higher degree of centrality and transdiagnostic overlap in the cross-sectional networks (invariants) and the cross-lagged panel network model of anxious and depressive symptomatology.
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Affiliation(s)
| | | | | | | | - Jacksaint Saintila
- Escuela de Medicina Humana, Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru.
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Zhang Y, Wu C, Ma J, Liu F, Shen C, Sun J, Ma Z, Hu W, Lang H. Relationship between depression and burnout among nurses in Intensive Care units at the late stage of COVID-19: a network analysis. BMC Nurs 2024; 23:224. [PMID: 38561758 PMCID: PMC10983623 DOI: 10.1186/s12912-024-01867-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses. METHOD A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure. RESULTS The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability. CONCLUSION The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.
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Affiliation(s)
- Yinjuan Zhang
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
- Department of Nursing, Shaanxi University of Chinese Medicine, Shiji Avenue, 712046, Xianyang, Shaanxi, China
| | - Chao Wu
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Jin Ma
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Fang Liu
- Department of Nursing, Shaanxi University of Chinese Medicine, Shiji Avenue, 712046, Xianyang, Shaanxi, China
| | - Chao Shen
- Department of Computer Science and Engineering, Xi'an Technological University, No. 4 Jinhua North Road, 710021, Xi'an, Shaanxi, China
| | - Jicheng Sun
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Zhujing Ma
- Department of Military Medical Psychology, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China
| | - Wendong Hu
- Department of Aerospace Medicine, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China.
| | - Hongjuan Lang
- Department of Nursing, Air Force Medical University, No. 169 Changle West Road, 710032, Xi'an, Shaanxi, China.
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Ma H, Zhao M, Liu Y, Wei P. Network analysis of depression and anxiety symptoms and their associations with life satisfaction among Chinese hypertensive older adults: a cross-sectional study. Front Public Health 2024; 12:1370359. [PMID: 38562253 PMCID: PMC10983850 DOI: 10.3389/fpubh.2024.1370359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Background Hypertension is one of the most prevalent chronic diseases among the older adult population in China and older adults with hypertension are more susceptible to mental health problems. This study aimed to explore the network structure of depression and anxiety, and their association with life satisfaction (LS) in older adults with hypertension. Methods A total of 4,993 hypertensive individuals aged 60 and above were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018). The design of the CLHLS study was approved by the Campus Institutional Review Board of Duke University (Pro00062871) and the Biomedical Ethics Committee of Peking University (IRB00001052-13,074). The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were used to assess depressive and anxiety symptoms. Central and bridge symptoms were identified via "Expected Influence" and "Bridge Expected Influence", respectively. Network stability was assessed using the case-dropping bootstrap technique. Results Network analysis identified CESD3 (Feeling blue/depressed), GAD4 (Trouble relaxing), and GAD2 (Uncontrollable worry) as the most influential central symptoms in the network of depression and anxiety. Concurrently, GAD1 (Nervousness or anxiety), CESD10 (Sleep disturbances), and CESD1 (Feeling bothered) stand as critical bridge symptoms between depression and anxiety disorders. Moreover, CESD7 (Lack of happiness) exhibited the strongest negative correlation with LS in Chinese hypertensive older adults. Conclusion This exploratory study represents the first investigation to examine the mutual relationship between depressive and anxiety symptoms among Chinese hypertensive older adults. Interventions addressing targeting bridge symptoms have the potential to alleviate depressive and anxiety symptoms. Furthermore, improving happiness, hope, and sleep quality in this population may mitigate the adverse effects of depression and anxiety on LS.
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Affiliation(s)
| | | | | | - Pingmin Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China
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10
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Chen Z, Xiong J, Ma H, Hu Y, Bai J, Wu H, Wang Y. Network analysis of depression and anxiety symptoms and their associations with mobile phone addiction among Chinese medical students during the late stage of the COVID-19 pandemic. SSM Popul Health 2024; 25:101567. [PMID: 38524176 PMCID: PMC10958643 DOI: 10.1016/j.ssmph.2023.101567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/18/2023] [Accepted: 11/19/2023] [Indexed: 03/26/2024] Open
Abstract
Network analysis provides a novel approach to discovering associations between mental disorders at the symptom level. This study aimed to examine the characteristics of the network of depression and anxiety symptoms and their associations with mobile phone addiction (MPA) among Chinese medical students during the late stage of the COVID-19 pandemic. A total of 553 medical students were included. Depression and anxiety symptoms and MPA were measured by the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the Mobile Phone Addiction Index (MPAI), respectively. Central and bridge symptoms were identified with centrality indices and bridge centrality indices. Network stability was examined using the case-dropping procedure. "Uncontrollable worry", "restlessness" and "nervousness" were the central symptoms in the depression and anxiety network. "Restlessness" and "motor" were the most central bridge symptoms linking depression and anxiety. "Concentration", "anhedonia" and "sleep" were most strongly associated with MPA. "Uncontrollable worry", "restlessness", "nervousness," and "motor" may be the symptoms for interventions to target in medical students with comorbid depression and anxiety. From a network perspective, depressive symptoms may be more important than anxiety symptoms in medical students with MPA.
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Affiliation(s)
- Zhihan Chen
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Jiexi Xiong
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Hongfei Ma
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Yunan Hu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Junni Bai
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Hui Wu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR China
| | - Yang Wang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, PR 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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Sun HL, Zhao YJ, Sha S, Li XH, Si TL, Liu YF, Su Z, Cheung T, Chang A, Liu ZM, Li X, Ng CH, An FR, Xiang YT. Depression and anxiety among caregivers of psychiatric patients during the late stage of the COVID-19 pandemic: A perspective from network analysis. J Affect Disord 2024; 344:33-40. [PMID: 37793475 DOI: 10.1016/j.jad.2023.09.034] [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: 11/22/2022] [Revised: 09/17/2023] [Accepted: 09/30/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Depressive and anxiety symptoms (depression and anxiety hereafter) are common among psychiatric patients and their caregivers during the COVID-19 pandemic. Network analysis is a novel method to assess the associations between psychiatric syndromes/disorders at the symptom level. This study examined depression and anxiety among caregivers of psychiatric inpatients during the late stage of the COVID-19 pandemic from the perspective of network analysis. METHODS A total of 1101 caregivers of psychiatric inpatients were included in this study. The severity of depression was assessed using the nine-item Patient Health Questionnaire (PHQ-9), while anxiety was assessed with the seven-item Generalized Anxiety Disorder Scale (GAD-7). The expected index (EI) and bridge EI index were used to identify the central and bridge symptoms, respectively. The stability of the network was evaluated via a case-dropping bootstrap procedure. RESULTS The prevalence of depression and anxiety were 32.4 % (95%CI: 29.7 %-35.3 %) and 28.0 % (95%CI: 25.4 %-30.7 %), respectively while the prevalence of comorbid depression and anxiety was 24.9 % (95%CI: 22.4 %-27.6 %). The most central symptom was "Fatigue", followed by "Trouble Relaxing" and "Restlessness". The highest bridge symptom was "Restlessness", followed by "Uncontrollable worry" and "Suicide ideation". The bootstrap test indicated that the whole network model was stable, and no network difference was detected between genders and between different education levels. CONCLUSIONS Depression, anxiety, and comorbid depression and anxiety were common among caregivers of psychiatric inpatients during the late stage of the COVID-19 pandemic. Central and bridge symptoms identified in this network analysis should be considered key target symptoms to address in caregivers of patients.
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Affiliation(s)
- He-Li Sun
- 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
| | - Yan-Jie Zhao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yu-Fei Liu
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Angela Chang
- Department of Communication, Faculty of Social Sciences, University of Macau, Macau SAR, China
| | - Zhao-Min Liu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, 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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13
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Hung DV, Thao PN, Lang HN, Thu LT, Tai PT, Toan PQ, Nhat DV, Tien NX, Chi LD, Thuan DD. Mental health impact on patients with COVID-19 in the community under a long period of full lockdown in Vietnam. J Int Med Res 2024; 52:3000605231221087. [PMID: 38259217 PMCID: PMC10807321 DOI: 10.1177/03000605231221087] [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: 07/03/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE We aimed to investigate the impact on the mental health of patients with COVID-19 in a centralized isolation facility in the community who experienced a long period of full lockdown during the fourth wave of the COVID-19 pandemic in Vietnam. METHODS We performed a retrospective cross-sectional study among 125 patients with COVID-19 in a centralized isolation facility in the community of Ho Chi Minh City from September to November 2021. We collected data on depression, anxiety, and stress symptoms, as indicated by scores on the Depression Anxiety Stress Scale-21, as well as sociodemographic characteristics. RESULTS The prevalence of depression, anxiety, and stress among patients with COVID-19 was 14.4%, 20.8%, and 20.0%, respectively. Depression scores were significantly and positively correlated with body mass index whereas stress scores were significantly and positively correlated with age. CONCLUSION Our findings indicated an increased prevalence of depression, anxiety, and stress among patients with COVID-19 who were in a centralized isolation facility during the fourth COVID-19 wave in Vietnam. Overweight and older age were identified as risk factors for adverse mental health in patients with COVID-19. Psychological intervention programs should be implemented in isolation facilities for individuals with COVID-19 infection.
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Affiliation(s)
- Dinh Viet Hung
- Department of Psychiatry, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Pham Ngoc Thao
- Department of Functional Diagnosis, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Huynh Ngoc Lang
- Department of Psychiatry, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Le Thi Thu
- Department of Traditional Medicine, 5 Military Hospital, Ninh Binh, Vietnam
| | - Pham The Tai
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, Ha Noi, Vietnam
| | - Pham Quoc Toan
- Department of Nephrology and Dialysis, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Dao Van Nhat
- Department of Urology, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
| | | | - Le Duy Chi
- Department of Ultrasound, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
| | - Do Duc Thuan
- Department of Stroke, 103 Military Hospital, Vietnam Military Medical University, Ha Noi, Vietnam
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Chen P, Sun HL, Li DH, Feng Y, Su Z, Cheung T, Cui XL, Ungvari GS, Jackson T, An FR, Xiang YT. A comparison of psychiatric symptoms between mental health professionals with and without post-infection sequelae of COVID-19. Psychiatry Res 2024; 331:115631. [PMID: 38101073 DOI: 10.1016/j.psychres.2023.115631] [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: 07/02/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
Post-infection sequelae of COVID-19 (PISC) have raised public health concerns. However, it is not clear whether infected mental health professionals (MHPs) with PISC have experienced more psychiatric symptoms than MHPs without PISC do. This study examined differences in the prevalence of self-reported depression, anxiety, insomnia and suicidality as well as the network structures of these symptoms between these two groups. Participants completed questionnaire measures of psychiatric symptoms and demographics. Expected influence was used to measure centrality of symptoms and network comparison tests were adopted to compare differences in the two network models. The sample comprised 2,596 participants without PISC and 2,573 matched participants with PISC. MHPs with PISC had comparatively higher symptom levels related to depression (55.2% vs. 23.5 %), anxiety (32.0% vs. 14.9 %), insomnia (43.3% vs. 17.3 %), and suicidality (9.6% vs. 5.3 %). PHQ4 ("Fatigue"), PHQ6 ("Guilt"), and GAD2 ("Uncontrollable Worrying") were the most central symptoms in the "without PISC" network model. Conversely, GAD3 ("Worry too much"), GAD5 ("Restlessness"), and GAD4 ("Trouble relaxing") were more central in the "with PISC" network model. In sum, MHPs with PISC experienced comparatively more psychiatric symptoms and related disturbances. Network results provide foundations for the expectation that MHPs with PISC may benefit from interventions that address anxiety-related symptoms, while those without PISC may benefit from interventions targeting depression-related symptoms.
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Affiliation(s)
- Pan 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
| | - He-Li Sun
- 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
| | - De-Hui Li
- School of Nursing, Capital Medical University, Beijing, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, 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
| | - Xi-Ling Cui
- Department of Business Administration, Hong Kong Shue Yan University Hong Kong, Hong Kong SAR, China
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, 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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15
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Lam MI, Chen P, Zhang Q, Sha S, An FR, Su Z, Cheung T, Ungvari GS, Ng CH, Xiang YT, Feng Y. Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey. Front Public Health 2023; 11:1280688. [PMID: 37965522 PMCID: PMC10642929 DOI: 10.3389/fpubh.2023.1280688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Background China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective. Methods A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function." Results A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048). Conclusion This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.
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Affiliation(s)
- Mei Ieng Lam
- 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
- Kiang Wu Nursing College of Macau, Macao, Macao SAR, 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, Taipa, 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, Capital Medical University, Beijing, China
| | - Sha Sha
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Gabor S. Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - 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, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Taipa, Macao SAR, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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Xia J, Zhu L, Huang H, Fan P, Zhou M, Cai XL, He H. Relationships between childhood trauma and mental health during the COVID-19 pandemic: a network analysis. Front Psychiatry 2023; 14:1251473. [PMID: 37743981 PMCID: PMC10515217 DOI: 10.3389/fpsyt.2023.1251473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Background Childhood trauma has been found to have an important impact on mental health. However, little is known regarding the intercorrelations between childhood trauma and mental health during the COVID-19 pandemic. This study aimed to investigate such complex interplay between childhood trauma, depression, anxiety, post-traumatic stress level during the COVID-19 pandemic, and fear of COVID-19 using network analysis. Methods A total of 1,247 college students were recruited and were asked to complete a series of questionnaires, including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Post-traumatic Stress Checklist-Civilian version, and Fear of COVID-19 Scale. The Gaussian graphical model with the scores of the questionnaires as nodes was estimated. The partial correlations between nodes were calculated as edges. Moreover, network comparison tests were conducted to compare the network patterns between participants with high levels of childhood trauma and low levels of childhood trauma. Results Childhood trauma was found to be connected to depression, anxiety, and post-traumatic stress level. The node of childhood trauma exhibited the strongest strength and the highest expected influence in the network. Participants with high levels of childhood trauma and participants with low levels of childhood trauma showed comparable network structure and global strength. Conclusion Our findings revealed a complex network pattern between childhood trauma and different mental health problems, indicating that childhood trauma might be a risk factor for mental health during the COVID-19 pandemic.
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Affiliation(s)
- Jinjin Xia
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Zhu
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
| | - Huayun Huang
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Pengfei Fan
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Meifeng Zhou
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
| | - Xin-lu Cai
- Institute of Brain Science and Department of Physiology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, China
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, China
- Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, China
| | - Hui He
- Department of Neurology, Changxing People’s Hospital of Zhejiang Province, Huzhou, China
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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17
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Jia S, Yu B, Feng C, Jia P, Xu P, Yang S. Occupational burnout, flourishing and job satisfaction among HIV/AIDS healthcare workers in Western China: a network analysis. BMC Psychiatry 2023; 23:560. [PMID: 37537528 PMCID: PMC10398953 DOI: 10.1186/s12888-023-04959-7] [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] [Received: 04/19/2023] [Accepted: 06/14/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Healthcare workers suffered with high prevalence of occupational burnout, which might be related with their job satisfaction and well-being. This study aimed to provide evidence of complex interrelations among occupational burnout, flourishing, and job satisfaction, and identify key variables from the perspective of network structure among healthcare workers. METHODS A cross-sectional study was conducted between July and October 2021, and 907 (the response rate was 98.4%) HIV/AIDS healthcare workers completed their sociodemographic characteristics, occupational burnout, flourishing and job satisfaction. Network analysis was conducted to investigate the interrelations of occupational burnout, flourishing, and job satisfaction communities, and identify central variables and bridges connecting different communities with different bridge strength thresholds in the network structure. The Network Comparison Test (NCT) was conducted to examine the gender differences in networks. RESULTS In the network, feeling exhausted at work (strength: 1.42) and feeling frustrated at work (1.27) in occupational burnout community, and interested in daily activities (1.32) in flourishing community were central variables. Bridges in the network were job reward satisfaction (bridge strength: 0.31), satisfaction with job itself (0.25), and job environment satisfaction (0.19) in job satisfaction community, as well as interested in daily activities (0.29) and feeling respectable (0.18) in flourishing community, with bridges selected with top 20% bridge strengths. Feeling frustrated at work (0.14) in occupational burnout community and leading a purposeful and meaningful life (0.11) in flourishing community became bridges when using thresholds of top 25% and 30% bridge strengths, respectively. We also observed higher network densities in females (network density: 0.37) than that in males (0.34), and gender differences in the distribution of partial correlation coefficients (M = 0.27, P = 0.017). CONCLUSIONS In the network structure of occupational burnout-flourishing-job satisfaction, feeling frustrated at work in occupational burnout community and interested in daily activities in flourishing community were both central variables and bridges, which may be targeted variables to intervene to alleviate the overall level of symptoms in the network and therefore prevent poor health outcomes in healthcare workers.
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Affiliation(s)
- Siyan Jia
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Peng Xu
- National Center for STD/AIDS Control and Prevention, China Center for Disease Control and Prevention, Beijing, China.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China.
- Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China.
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Peng P, Wang Y, Li Z, Zhou Y, Wang J, Qu M, Liu T. A network analysis of the long-term quality of life and mental distress of COVID-19 survivors 1 year after hospital discharge. Front Public Health 2023; 11:1223429. [PMID: 37575111 PMCID: PMC10416228 DOI: 10.3389/fpubh.2023.1223429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
Objectives COVID-19 survivors suffer from persistent mental distress and impaired quality of life (QOL) after recovery from the infection. However, the symptom-symptom interaction between these psychological variables remained unexplored. The present study aimed to determine the symptom network of mental distress (depression, anxiety, sleep disturbance, fatigue, and post-traumatic stress disorder) and their association with QOL among 535 COVID-19 survivors 1 year after hospital discharge. Methods 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, Chalder fatigue scale, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and 36-Item Short-Form Health Survey were applied to measure depression, anxiety, fatigue, PTSD, sleep disturbances, and QOL, respectively. Two networks were estimated using Gaussian graphical model. Network 1 consisted of mental symptoms to determine the central and bridge symptoms. Network 2 additionally included QOL to determine which mental symptoms were mostly related to QOL. Results 60% of the COVID-19 survivors experienced mental distress 1 year after hospital discharge. Uncontrollable and excessive worry, psychomotor symptoms, intrusion, and daytime dysfunction were the most central symptoms. Daytime dysfunction and fatigue (especially mental fatigue and loss of energy) served as the bridge symptoms across the mental distress network and exhibited the most substantial association with QOL. Conclusion Our study demonstrated several key symptoms that played a vital role in mental distress and QOL among COVID-19 survivors. Prompt screening and targeted interventions for these symptoms might hold great promise in preventing mental distress and improving QOL in COVID-19 survivors.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yaqi Wang
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhuqing Li
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China
| | - Yanan Zhou
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People’s Hospital), Changsha, China
| | - Ji Wang
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China
| | - Miao Qu
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Wu K, Li Y, Pan Y, Qiu J, Chen X, Fan Y, Xing Y, Zhou X. Impact of closed management on gastrointestinal function and mental health of Chinese university students during COVID-19. BMC Public Health 2023; 23:1219. [PMID: 37353824 PMCID: PMC10288672 DOI: 10.1186/s12889-023-16145-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/18/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND The innovative closed management of universities may have influenced the physical and mental health of students during the fourth stage of the COVID-19 pandemic in China. The study aimed to assess the gastrointestinal and mental health status of students in this stage and to explore the possible risk factors and mechanisms to provide a reference for future school responses to similar stressful events. METHOD A multicenter, cross-sectional survey was administered to 598 college students from 10 Chinese universities. The study used the 7-item Generalized Anxiety Disorder Scale (GAD-7), 9-item Patient Health Questionnaire (PHQ-9), Fear of COVID-19 Scale (FCV-19 S), and the Diagnostic Tendency of Functional Bowel Disease Scale (DT-FBD) to evaluate anxiety, depression, fear of COVID-19 and likelihood of being diagnose diagnosed with functional bowel disease (FBD), respectively. RESULTS A total of 516 college students completed the questionnaire. The proportions of students with more severe anxiety, more severe depression, greater fear of COVID-19, and a greater likelihood of being diagnosed with FBD were 49.8%, 57.0%, 49%, and 49%, respectively. These symptoms were significantly and positively correlated with the frequency of irregular sleep and eating (p < 0.05). Students in high-risk areas were more likely to experience anxiety and depression than students in areas with low/medium risk (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.12-3.24, p = 0.017; OR = 2.14, 95% CI: 1.11-4.11, p = 0.022). A high likelihood of being diagnosed with FBD was positively associated with the severity of anxiety and depression symptoms and fear of COVID-19 (all p < 0.001). Moreover, mediation analysis revealed the following pathway in college students: fear of COVID-19 → depression and anxiety → poor diet → likelihood of being diagnosed with FBD. CONCLUSION College students generally exhibited higher more severe anxiety and depression symptoms and psychological symptoms with a greater higher propensity likelihood of being to be diagnosed with FBD. Good lifestyle habits, especially adequate sleep and a regular diet, can alleviate these problems. In addition, appropriate psychological intervention is very important.
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Affiliation(s)
- Kaini Wu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China
| | - Yi Li
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China
| | - Yating Pan
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China
| | - Jianhao Qiu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China
| | - Xiaqin Chen
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China
| | - Yuanping Fan
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China
| | - Yawei Xing
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China.
| | - Xiaodong Zhou
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, 330006, Jiangxi Province, China.
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Park M, Seo D, Kim JG, Lee G, McReynolds LS, Amsel L, Yang H, Kim YH, Han S, Park SH, Hur J. Identification and comparison of pandemic-to-symptom networks of South Korea and the United States. Front Psychiatry 2023; 14:1161200. [PMID: 37426108 PMCID: PMC10328092 DOI: 10.3389/fpsyt.2023.1161200] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Background The Coronavirus (COVID-19) pandemic resulted in a dramatic increase in the prevalence of anxiety and depression globally. Although the impact on the mental health of young adults was especially strong, its underlying mechanisms remain elusive. Materials and methods Using a network approach, the present study investigated the putative pathways between pandemic-related factors and anxiety and depressive symptoms among young adults in South Korea and the U.S. Network analyses were conducted on cross-country data collected during the COVID-19 lockdown period (n = 1,036). Our model included depression symptoms (PHQ-9), generalized anxiety symptoms (GAD-7), and COVID-19-related factors (e.g., COVID-19-related traumatic stress, pandemic concerns, access to medical/mental health services). Results The overall structure of pandemic-to-symptom networks of South Korea and the U.S. were found to be similar. In both countries, COVID-related stress and negative future anticipation (an anxiety symptom) were identified as bridging nodes between pandemic-related factors and psychological distress. In addition, worry-related symptoms (e.g., excessive worry, uncontrollable worry) were identified as key contributors in maintaining the overall pandemic-to-symptom network in both countries. Conclusion The similar network structures and patterns observed in both countries imply that there may exist a stable relationship between the pandemic and internalizing symptoms above and beyond the sociocultural differences. The current findings provide new insights into the common potential pathway between the pandemic and internalizing symptoms in South Korea and in the U.S. and inform policymakers and mental health professionals of potential intervention targets to alleviate internalizing symptoms.
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Affiliation(s)
- Mijeong Park
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Deachul Seo
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Ji Geun Kim
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Gayeon Lee
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Larkin S. McReynolds
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Lawrence Amsel
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
| | - Hyunjung Yang
- University College, Yonsei University, Seoul, Republic of Korea
| | - Young-Hoon Kim
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Sanghoon Han
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Soo Hyun Park
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Juyoen Hur
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
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21
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Lin Y, Bai W, Liu HH, Li ZZ, Gao ZZ, Han T, Ren HH, Ng CH, Xiang YT. Prevalence, correlates, and network analysis of depression and its association with quality of life in survivors with myocardial infarction during the COVID-19 pandemic. J Affect Disord 2023:S0165-0327(23)00731-0. [PMID: 37247785 DOI: 10.1016/j.jad.2023.05.086] [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: 12/11/2022] [Revised: 03/21/2023] [Accepted: 05/23/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Depression is common among myocardial infarction (MI) survivors and is strongly associated with poor quality of life (QOL). The aim of this study was to examine the prevalence, correlates and the network structure of depression, and its association with QOL in MI survivors during the COVID-19 pandemic. METHODS This cross-sectional study evaluated depression and QOL in MI survivors with the Chinese version of the nine-item Patient Health Questionnaire (PHQ-9) and World Health Organization Quality of Life-BREF (WHOQOL-BREF) respectively. Univariable analyses, multivariable analyses, and network analyses were performed. RESULTS The prevalence of depression (PHQ-9 total score ≥ 5) among 565 MI survivors during the COVID-19 pandemic was 38.1 % (95 % CI: 34.1-42.1 %), which was significantly associated with poor QOL. Patients with depression were less likely to consult a doctor regularly after discharge, and more likely to experience more severe anxiety symptoms and fatigue. Item PHQ4 "Fatigue" was the most central symptom in the network, followed by PHQ6 "Guilt" and PHQ2 "Sad mood". The flow network showed that PHQ4 "Fatigue" had the highest negative association with QOL. CONCLUSION Depression was prevalent among MI survivors during the COVID-19 pandemic and was significantly associated with poor QOL. Those who failed to consult a doctor regularly after discharge or reported severe anxiety symptoms and fatigue should be screened for depression. Effective interventions for MI survivors targeting central symptoms, especially fatigue, are needed to reduce the negative impact of depression and improve QOL.
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Affiliation(s)
- Yun Lin
- Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Wei Bai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao; Centre for Cognitive and Brain Sciences, University of Macau, Macao
| | - Hong-Hong Liu
- Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Zhi-Zhong Li
- Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Zheng-Zhuo Gao
- Department of Medicine, Capital Medical University, Beijing, China
| | - Tuo Han
- Department of Medicine, Capital Medical University, Beijing, China
| | - Hui-Hao Ren
- Department of Medicine, Capital Medical University, Beijing, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, 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; Centre for Cognitive and Brain Sciences, University of Macau, Macao.
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22
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Kim ST, Seo JH, Park CI, Kim SJ, Kang JI. COVID-19 pandemic’s impact on networks of depression and anxiety in naturalistic transdiagnostic sample of outpatients with non-psychotic mental illness. Front Psychiatry 2023; 14:1118942. [PMID: 36993919 PMCID: PMC10040589 DOI: 10.3389/fpsyt.2023.1118942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
BackgroundThe 2019 coronavirus disease (COVID-19) pandemic has caused an unprecedented disruption of daily lives and a mental health crisis. The present study examined how the depression and anxiety symptom network changed during the COVID-19 pandemic in a naturalistic transdiagnostic sample with non-psychotic mental illness.Materials and methodsA total of 224 psychiatric outpatients before the pandemic and 167 outpatients during the pandemic were included in the study and were assessed for the Patient Health Questionnaire and the Beck Anxiety Inventory. The network of depression and anxiety symptoms before and during the pandemic were estimated separately and were assessed differences.ResultsThe network comparison analysis showed a significant structural difference between the networks before and during the pandemic. Before the pandemic, the most central symptom in the network was feelings of worthlessness, while in the during pandemic network, somatic anxiety emerged as the most central node. Somatic anxiety, which showed the highest strength centrality during the pandemic, showed significantly increased correlation with suicidal ideation during the pandemic.LimitationsThe two cross-sectional network analyses of individuals at one point in time cannot demonstrate causal relationships among measured variables and cannot be assumed to generalize to the intraindividual level.ConclusionThe findings indicate that the pandemic has brought a significant change in the depression and anxiety network and somatic anxiety may serve as a target for psychiatric intervention in the era of the pandemic.
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Affiliation(s)
- Shin Tae Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun Ho Seo
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Kangwon, Republic of Korea
| | - Chun Il Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Se Joo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee In Kang
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- *Correspondence: Jee In Kang,
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23
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Wei Y, Li Z, Guo L, Zhang L, Lian C, Yuan C, Chen J. The Moderating Role of Family Resilience on the Relationship between COVID-19-Related Psychological Distress and Mental Health among Caregivers of Individuals with Eating Disorders in Post-Pandemic China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3417. [PMID: 36834112 PMCID: PMC9965091 DOI: 10.3390/ijerph20043417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 has amplified long-standing emotional distress for vulnerable families. While abundant research highlights the importance of resilience under adverse circumstances, little has been undertaken to understand its effectiveness in helping caregivers of individuals with eating disorders (ED) navigate pandemic-related challenges. This paper presents findings of a cross-sectional study investigating the effects of COVID-19-related life disruptions (COLD) and COVID-19-related psychological distress (CORPD) on caregivers' depression, anxiety and stress, as well as the moderation role of individual resilience (IR) and family resilience (FR) during the post-pandemic period in China. A total of 201 caregivers of individuals experiencing ED participated in our online survey from May 2022 to June 2022. The association between pandemic-related stressors (i.e., COLD and CORPD) and mental health conditions were confirmed. FR moderated the relationship between CORPD and mental health outcomes, while IR independently contributed to low emotional distress. We call for intervention programs strengthening caregivers' FR and IR, which might benefit both patients and caregivers' well-being in the post-pandemic period.
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Affiliation(s)
| | | | | | | | | | - Chengmei Yuan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
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24
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Li K, Luo K, Zhan X, Liu C, Li L, Luo X, Ren L, Wang L, Feng Z. Adjusting intervention strategies for mental health of COVID-19 patients: A network analysis based on a survey in Omicron-infected patients. Front Public Health 2022; 10:1038296. [PMID: 36466516 PMCID: PMC9714331 DOI: 10.3389/fpubh.2022.1038296] [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: 09/06/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background The COVID-19 pandemic had a major impact on people's mental health. As the SAS-Cov-2 evolves to become less virulent, the number of asymptomatic patients increases. It remains unclear if the mild symptoms are associated with mild perceived stress and mental illness, and the interventions to improve the mental health of the patients are rarely reported. Methods This cross-sectional study investigated the level of depression, anxiety and perceived stress of 1,305 COVID-19 patients who received treatment in the Fangcang shelter hospitals in Shanghai, China. Network analysis was used to explore the relationship among depression, anxiety and perceived stress. Results The prevalence of depression, anxiety and perceived stress in the patients with Omicron infection were 9.03, 4.60, and 17.03%, respectively, lower than the prevalence reported during the initial outbreak of COVID-19. "Restlessness (A5)," "Uncontrollable worry (A2)," "Trouble relaxing (A4)" and "Fatigue (D4)" had the highest expected influence values. "Irritability (A6)" and "Uncontrollable (S1)" were bridge symptoms in the network. Comparative analysis of the network identified differences in the network structures between symptomatic and asymptomatic patients. Conclusion This study investigated the prevalence of depression, anxiety and perceived stress and the correlation among them in Omicron-infected patients in Fangcang shelter hospital, in Shanghai, China. The core symptoms identified in the study provide insight into targeted clinical prevention and intervention of mental health in non-severe Omicron-infected patients.
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Affiliation(s)
- Kuiliang Li
- School of Psychology, Army Medical University, Chongqing, China
| | - Keyong Luo
- Department of Psychiatry, The 980th Hospital of PLA Joint Logistics Support Force, Shijiazhuang, China
| | - Xiaoqing Zhan
- Department of Medical English, College of Basic Medicine, Army Medical University, Chongqing, China
| | - Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Ling Li
- College of General Education, Chong Qing Water Resources and Electric Engineering College, Chongqing, China
| | - Xi Luo
- Department of Medical English, College of Basic Medicine, Army Medical University, Chongqing, China
| | - Lei Ren
- Department of Psychology, Fourth Military Medical University, Xi'an, China,*Correspondence: Lei Ren
| | - Lingzhi Wang
- Sichuan Shun Dao Law Firm, Chengdu, China,Lingzhi Wang
| | - Zhengzhi Feng
- School of Psychology, Army Medical University, Chongqing, China,Zhengzhi Feng
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25
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Peng P, Chen Q, Liang M, Liu Y, Chen S, Wang Y, Yang Q, Wang X, Li M, Wang Y, Hao Y, He L, Wang Q, Zhang J, Ma Y, He H, Zhou Y, Li Z, Xu H, Long J, Qi C, Tang YY, Liao Y, Tang J, Wu Q, Liu T. A network analysis of anxiety and depression symptoms among Chinese nurses in the late stage of the COVID-19 pandemic. Front Public Health 2022; 10:996386. [PMID: 36408014 PMCID: PMC9667894 DOI: 10.3389/fpubh.2022.996386] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/10/2022] [Indexed: 01/26/2023] Open
Abstract
Background Nurses are at high risk for depression and anxiety symptoms after the outbreak of the COVID-19 pandemic. We aimed to assess the network structure of anxiety and depression symptoms among Chinese nurses in the late stage of this pandemic. Method A total of 6,183 nurses were recruited across China from Oct 2020 to Apr 2021 through snowball sampling. We used Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder scale-7 (GAD-7) to assess depression and anxiety, respectively. We used the Ising model to estimate the network. The index "expected influence" and "bridge expected influence" were applied to determine the central symptoms and bridge symptoms of the anxiety-depression network. We tested the stability and accuracy of the network via the case-dropping procedure and non-parametric bootstrapping procedure. Result The network had excellent stability and accuracy. Central symptoms included "restlessness", "trouble relaxing", "sad mood", and "uncontrollable worry". "Restlessness", "nervous", and "suicidal thoughts" served as bridge symptoms. Conclusion Restlessness emerged as the strongest central and bridge symptom in the anxiety-depression network of nurses. Intervention on depression and anxiety symptoms in nurses should prioritize this symptom.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiongni Chen
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Mining Liang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yueheng Liu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shubao Chen
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yunfei Wang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qian Yang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xin Wang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Manyun Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yingying Wang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Li He
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Junhong Zhang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuejiao Ma
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haoyu He
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Department of Psychology, College of Education, Hunan First Normol University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital, Changsha, China
| | - Zejun Li
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huixue Xu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiang Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chang Qi
- Department of Psychiatry, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qiuxia Wu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,Qiuxia Wu
| | - Tieqiao Liu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China,*Correspondence: Tieqiao Liu
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Handayani S, Nurmandhani R, Hinchcliff R. Quality of Life Among People with Positive COVID-19 Experience in Semarang, Indonesia. BIO WEB OF CONFERENCES 2022. [DOI: 10.1051/bioconf/20225400013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has affected many ways of life, especially among people who experience the infection. The pandemic negatively affected the physical, social, and psychological functioning of individuals and societies, worldwide. This study aimed to evaluate the extent to which key factors may influence the QoL of people with COVID-19 in Semarang, Indonesia. The online cross-sectional study recruited 107 participants. Adults (≥ 17 years of age) with positive COVID-19 infection history were targeted. Quality of life was measured with the WHOQOL-BREF questionnaire. The questions explain how respondents attribute to each aspect of their life and how problematic or satisfactory they perceive them for their overall quality of life. Results showed that the highest mean score was found for the social domain (14.112.89), and the lowest mean score was observed for the environment domain (13.272.01). The presence of comorbidities had a statistically significant difference in the environment domain (p-value:0.006). During the COVID-19 pandemic, people had less satisfaction with their environment. The presence of anxiety often promotes changes in the perception of QoL for all domains among respondents (p-value: <0.0001). Investing such resources in these groups may be an efficient option to maximize positive public health impacts in this resource-poor environment.
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