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Liu J, Gui Z, Chen P, Cai H, Feng Y, Ho TI, Rao SY, Su Z, Cheung T, Ng CH, Wang G, Xiang YT. A network analysis of the interrelationships between depression, anxiety, insomnia and quality of life among fire service recruits. Front Public Health 2024; 12:1348870. [PMID: 39022427 PMCID: PMC11252005 DOI: 10.3389/fpubh.2024.1348870] [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: 12/03/2023] [Accepted: 05/27/2024] [Indexed: 07/20/2024] Open
Abstract
Background Research on the mental health and quality of life (hereafter QOL) among fire service recruits after the end of the COVID-19 restrictions is lacking. This study explored the network structure of depression, anxiety and insomnia, and their interconnections with QOL among fire service recruits in the post-COVID-19 era. Methods This cross-sectional study used a consecutive sampling of fire service recruits across China. We measured the severity of depression, anxiety and insomnia symptoms, and overall QOL using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI) questionnaire, and World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. We estimated the most central symptoms using the centrality index of expected influence (EI), and the symptoms connecting depression, anxiety and insomnia symptoms using bridge EI. Results In total, 1,560 fire service recruits participated in the study. The prevalence of depression (PHQ-9 ≥ 5) was 15.2% (95% CI: 13.5-17.1%), while the prevalence of anxiety (GAD-7 ≥ 5) was 11.2% (95% CI: 9.6-12.8%). GAD4 ("Trouble relaxing") had the highest EI in the whole network model, followed by ISI5 ("Interference with daytime functioning") and GAD6 ("Irritability"). In contrast, PHQ4 ("Fatigue") had the highest bridge EI values in the network, followed by GAD4 ("Trouble relaxing") and ISI5 ("Interference with daytime functioning"). Additionally, ISI4 "Sleep dissatisfaction" (average edge weight = -1.335), which was the central symptom with the highest intensity value, had the strongest negative correlation with QOL. Conclusion Depression and anxiety were important mental health issues to address among fire service recruits in the post-COVID-19 era in China. Targeting central and bridge symptoms identified in network analysis could help address depression and anxiety among fire service recruits in the post-COVID-19 era.
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Affiliation(s)
- Jian Liu
- Department of Rehabilitation Medicine, China Emergency General Hospital, Beijing, China
| | - Zhen Gui
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, 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, Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macao SAR, China
| | - Hong Cai
- Unit of Medical Psychology and Behavior Medicine, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Tin-Ian Ho
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China
| | - Shu-Ying Rao
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, 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
| | - Chee H. Ng
- Department of Psychiatry, TheMelbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, Victoria, VIC, Australia
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders and 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, Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau, Macao SAR, China
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Luo J, Bei DL, Zheng C, Jin J, Yao C, Zhao J, Gong J. The comorbid network characteristics of anxiety and depressive symptoms among Chinese college freshmen. BMC Psychiatry 2024; 24:297. [PMID: 38641813 PMCID: PMC11027377 DOI: 10.1186/s12888-024-05733-z] [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: 02/06/2024] [Accepted: 04/02/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND This study aimed to investigate the interplay between anxiety and depressive symptoms in Chinese college freshmen using the causal system perspective (CSP), which differs from the traditional common cause perspective (CCP) by providing an alternative explanation by attributing comorbidity to direct interactions among symptoms. METHODS A convenience sample of 2,082 Chinese college freshmen (39.51% male, Mage = 18.61) from a normal university completed the Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9). Network analysis was conducted and evaluated as to centrality, stability, node predictability, and bridging features. Moreover, the moderated network model (MNM) was utilized to detect the moderation effects of gender in the comorbidity network. RESULTS The network of anxiety and depressive symptoms exhibited stability, characterized by the core symptoms of "restlessness", "lack of energy", and "excessive worry about control", as well as the bridging symptoms of "fearfulness", "sad mood", and "irritability". Notably, the nodes representing "uncontrollable worry" and "difficulty in relaxation" demonstrated the highest predictive power. Gender did not exert any moderating effects on the anxiety and depressive symptom network. CONCLUSION These results reinforce that certain anxiety or depressive symptoms are more central than others, and thus play a more vital role in the comorbid network. These findings highlight underlying potential targeting symptoms to consider in future interventions.
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Affiliation(s)
- Jie Luo
- School of Psychology, Guizhou Normal University, Guiyang, China.
| | - Dong-Li Bei
- School of Psychology, Guizhou Normal University, Guiyang, China
| | | | - Jie Jin
- School of Economic and Management, Guizhou Normal University, Guiyang, China
| | - Chengkui Yao
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Jianhua Zhao
- Journal Editorial Department, Guizhou Normal University, Guiyang, China
| | - Jie Gong
- The School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
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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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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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Wang S, Luo G, Pan D, Ding X, Yang F, Zhu L, Wang S, Ma X. Anxiety prevalence and associated factors among frontline nurses following the COVID-19 pandemic: a large-scale cross-sectional study. Front Public Health 2023; 11:1323303. [PMID: 38145071 PMCID: PMC10740197 DOI: 10.3389/fpubh.2023.1323303] [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: 10/17/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Nurses are more likely to experience anxiety following the coronavirus 2019 epidemic. Anxiety could compromise nurses' work efficiency and diminish their professional commitment. This study aims to investigate nurses' anxiety prevalence and related factors following the pandemic in multiple hospitals across China. Methods An online survey was conducted from April 16 to July 3, 2023, targeting frontline nurses who had actively participated in China. Anxiety and depression symptoms were assessed using the Self-rating Anxiety Scale and the Self-rating Depression Scale (SDS), respectively. Multivariable logistic regression analysis was employed to identify factors linked with anxiety. Results A total of 2,210 frontline nurses participated in the study. Overall, 65.07% of participants displayed clinically significant anxiety symptoms. Multivariable logistic regression revealed that nurses living with their families [2.52(95% CI: 1.68-3.77)] and those with higher SDS scores [1.26(95% CI: 1.24-1.29)] faced an elevated risk of anxiety. Conversely, female nurses [0.02(95% CI: 0.00-0.90)] and those who had recovered from infection [0.05(95%CI: 0.07-0.18)] demonstrated lower rates of anxiety. Discussion This study highlights the association between SDS score, gender, virus infection, living arrangements and anxiety. Frontline nurses need to be provided with emotional support to prevent anxiety. These insights can guide interventions to protect the mental well-being of frontline nurses in the post-pandemic period.
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Affiliation(s)
- Shitao Wang
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China
| | - Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Dongsheng Pan
- Department of Clinical Medicine, Anhui Medical University, Hefei, China
| | - XiangQian Ding
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, China
| | - Fei Yang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Liping Zhu
- Ya'an People's Hospital, Sichuan University, Yaan, China
| | - Shuo Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Xuelu Ma
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China
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Zhang L, Zhu W, Wu B. Network analysis of depression and anxiety symptoms in Chinese rheumatoid arthritis patients. PeerJ 2023; 11:e16356. [PMID: 37953775 PMCID: PMC10634336 DOI: 10.7717/peerj.16356] [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: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Background Rheumatoid arthritis (RA) patients are susceptible to comorbid anxiety and depression. From the network model perspective, comorbidity is due to direct interactions between depression and anxiety symptoms. The objective of this study was to assess the network structure of depression and anxiety symptoms in Chinese RA patients and identify the central and bridge symptoms as well as how depression and anxiety symptoms are related to quality of life (QoL) in the network. Methods A total of 402 Chinese RA patients were included in this study. Depression and anxiety symptoms were measured by the Hospital Anxiety and Depression Scale (HADS). R software was used to estimate the network. Specifically, we computed the predictability, expected influence (EI) and bridge expected influence (BEI) for each symptom and showed a flow network of "QoL". Results Our network revealed that the strongest edge was D2 "See the bad side of things" and D3 "Not feeling cheerful" across the whole network. For centrality indices, D3 "Not feeling cheerful" and D6 "Feeling down" had the highest EI values in the network, while A4 "Trouble relaxing" and D6 "Feeling down" had the highest BEI values of their respective community. As to "QoL", the strongest direct edge related to it was A1 "Nervousness". Conclusions "Feeling down" and "Not feeling cheerful" emerged as the strongest central symptoms, while "Trouble relaxing" and "Feeling down" were bridge symptoms in the anxiety-depression network of RA patients. Intervention on depression and anxiety symptoms in nurses should prioritize these symptoms.
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Affiliation(s)
- Lijuan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Zhu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beiwen Wu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Peng P, Chen S, Hao Y, He L, Wang Q, Zhou Y, Tang YY, Yang WF, Wu Q, Liu T. Network of burnout, depression, anxiety, and dropout intention in medical undergraduates. Int J Soc Psychiatry 2023; 69:1520-1531. [PMID: 37092762 DOI: 10.1177/00207640231166629] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Burnout, depression, and anxiety are highly prevalent among medical students, which often leads to their attrition. We aim to assess the inter-relationships of depression, burnout, and anxiety symptoms with dropout intention among Chinese medical undergraduates using the network analysis. METHOD A total of 3,648 Chinese medical undergraduates were recruited through snowball sampling. Learning burnout scale, 9-item Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder Scale (GAD-7) was used to assess burnout, depression, and anxiety symptoms, respectively. We used the EBICglasso model to estimate the network. We compared the network based on gender, study phase, and clinical experience. RESULTS After removing repeated submissions and incorrect responses to the trap question, 3,536 participants were included in the final analysis. The prevalence of burnout, depression, anxiety, and dropout intention was 38, 62.7, 38.4, and 39% respectively, which is consistent with previous findings. Network analysis suggested that anxiety and depression items clustered together and displayed several strong bridge connections, while burnout items formed another cluster. All the strongest edges were within the respective distress. Cynicism symptoms 'I am fed up with study' and 'I want to study but I feel that studying is boring' were the most central symptoms, while 'fatigue' and 'worthless' were the bridge symptoms within the burnout-depression-anxiety network. Other central symptoms included 'worthless', 'I can handle my courses', 'nervous', and 'uncontrollable worry'. Cynicism symptoms 'I am interested in my major' and 'I feel that the knowledge I have learned is useless' were mostly related to dropout intention. Gender, study phase, and clinical experience didn't affect the global strength of the burnout-depression-anxiety network. CONCLUSION Our results indicated the predominance of cynicism symptoms within the burnout-depression-anxiety network and its substantial impact on dropout intention, suggesting that early detection and intervention for cynicism symptoms in Chinese medical students are in urgent need. Other central and bridge symptoms might also serve as potential targets for the prevention and treatment of burnout, depression, and anxiety among medical students. For example, studies suggest cognitive-behavioral therapy could quickly improve 'worthless', which might be beneficial in treating burnout, depression, and anxiety in medical students.
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Affiliation(s)
- Pu Peng
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
| | - Shubao Chen
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhu Hao
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
| | - Li He
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Winson Fuzun Yang
- Meditation Research Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Qiuxia Wu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, Second Xiangya Hospital, Central South University, Changsha, 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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