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. 2025 Feb 25;15(1):6699.
doi: 10.1038/s41598-025-91025-9.

A network analysis of the heterogeneity and associated risk and protective factors of depression and anxiety among college students

Chunjuan Niu #  1   2 , Yaye Jiang #  1 , Yihui Li  1 , Xudong Wang  1 , Huiyuan Zhao  1 , Zhengshu Cheng  1 , Xiaoran Li  1 , Xu Zhang  1 , Zhiwei Liu  1 , Xiaoyu Yu  1 , Yan Peng  3   4   5
Affiliations

A network analysis of the heterogeneity and associated risk and protective factors of depression and anxiety among college students

Chunjuan Niu et al. Sci Rep. .

Abstract

Background: Comorbidity of depression and anxiety is common among adolescents and can lead to adverse outcomes. However, there is limited understanding of the latent characteristics and mechanisms governing these disorders and their interactions. Moreover, few studies have examined the impacts of relevant risk and protective factors.

Methods: This cross-sectional study involved 1,719 students. Mplus 8.0 software was used to conduct latent profile analysis to explore the potential categories of depression and anxiety comorbidities. R4.3.2 software was used to explore the network of core depression and anxiety symptoms, bridge these disorders, and evaluate the effects of risk and protective factors.

Results: Three categories were established: "healthy" (57.8%), "mild depression-mild anxiety" (36.6%), and "moderately severe depression-moderate anxiety" (5.6%). "Depressed mood", "nervousness", and "difficulty relaxing" were core symptoms in both the depression-anxiety comorbidity network and the network of risk and protective factors. Stress perception and neuroticism serve as bridging nodes connecting some symptoms of depression and anxiety and are thus considered the most prominent risk factors.

Conclusions: According to the core and bridging symptoms identified in this study, targeted intervention and treatment can be provided to groups with comorbid depression and anxiety, thereby reducing the risk of these comorbidities in adolescents.

Keywords: Anxiety; Depression; Latent profile analysis; Network analysis.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: Informed consent was obtained from all participants and the study procedures were carried out in accordance with the Declaration of Helsinki guidelines. Ethical approval was obtained from the Ethics Committee of North China University Of Science And Technology (N0.2021037).

Figures

Fig. 1
Fig. 1
Estimated conditional mean for each latent class.
Fig. 2
Fig. 2
Depression and anxiety symptoms network.
Fig. 3
Fig. 3
Centrality index(a) and Bridge Expected Influence(b) for depression and anxiety symptoms network.
Fig. 4
Fig. 4
Risk and protective factors with anxiety and depression comorbidity network.
Fig. 5
Fig. 5
Expected Influence(a) and Bridge Expected Influence(b) for risk and protective factors with anxiety and depression comorbidity network.
See this image and copyright information in PMC

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