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. 2021 Dec 17;11(1):638.
doi: 10.1038/s41398-021-01738-4.

Anxiety and depressive symptoms in college students during the late stage of the COVID-19 outbreak: a network approach

Wei Bai #  1   2   3 , Hong Cai #  1   2   3 , Shou Liu #  4 , Xu Chen #  5 , Sha Sha  6 , Teris Cheung  7 , Jessie Jingxia Lin  8 , Xiling Cui  9 , Chee H Ng  10 , Yu-Tao Xiang  1   2   3
Affiliations

Anxiety and depressive symptoms in college students during the late stage of the COVID-19 outbreak: a network approach

Wei Bai et al. Transl Psychiatry. .

Abstract

Mental health problems are common in college students even in the late stage of the coronavirus disease 2019 (COVID-19) outbreak. Network analysis is a novel approach to explore interactions of mental disorders at the symptom level. The aim of this study was to elucidate characteristics of depressive and anxiety symptoms network in college students in the late stage of the COVID-19 outbreak. A total of 3062 college students were included. The seven-item Generalized Anxiety Disorder Scale (GAD-7) and nine-item Patient Health Questionnaire (PHQ-9) were used to measure anxiety and depressive symptoms, respectively. Central symptoms and bridge symptoms were identified based on centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. The strongest direct relation was between anxiety symptoms "Nervousness" and "Uncontrollable worry". "Fatigue" has the highest node strength in the anxiety and depression network, followed by "Excessive worry", "Trouble relaxing", and "Uncontrollable worry". "Motor" showed the highest bridge strength, followed by "Feeling afraid" and "Restlessness". The whole network was robust in both stability and accuracy tests. Central symptoms "Fatigue", "Excessive worry", "Trouble relaxing" and "Uncontrollable worry", and critical bridge symptoms "Motor", "Feeling afraid" and "Restlessness" were highlighted in this study. Targeting interventions to these symptoms may be important to effectively alleviate the overall level of anxiety and depressive symptoms in college students.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Network structure of anxiety and depressive symptoms in college students.
The left panel shows the visualization of the network structure; the right panel shows the value of strength in order.
Fig. 2
Fig. 2. Network structure of anxiety and depressive symptoms showing bridge symptoms in college students.
The left panel shows the visualization of the network structure of bridging symptoms; the right panel shows the value of bridge strength in order.
Fig. 3
Fig. 3. The stability of strength and bridge strength using case-dropping bootstrap.
The x-axis indicates the percentage of cases of the original sample included at each step. The y-axis indicates the average of correlations between the centrality indices from the original network and the centrality indices from the networks that were re-estimated after excluding increasing percentages of cases.
See this image and copyright information in PMC

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