Abstract
The prevalence of comorbid depression and anxiety has increased significantly over the last three years. Herein, we used network analysis to identify core symptoms and comorbid pathways between the two disorders, and reveal temporal changes in symptoms that traditional assessment tools fail to capture. Data was collected from 787 clinically comorbid patients (mean age: 31.8 years, 67.1% female) who completed the Zung Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after treatment (T1 → T2) from 2019 to 2022. Node and bridge strengths were calculated, and the Network Comparison Test (NCT) was used to explore network differences from T1 to T2 and across gender groups. Results indicate that emptiness exhibited the highest strength centrality, particularly among adolescents. The strongest bridge nodes were found in the emotional, physical, and psychological symptoms communities of the two disorders. Although the total score of the assessment tools decreased during treatment, NCT confirmed a significant increase in the overall strength of the network (p = .03). Notably, mental agitation exhibited higher strength within the male network. In conclusion, our findings provide further insights into the mechanisms of comorbid symptomatology and its evolution during treatment, offering valuable targets for intervention. Thus, suggesting the inclusion of network analysis in existing diagnostic, treatment, and follow-up processes facilitates personalized interventions and enhances patient recovery.
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Data availability
The datasets analysed during the current study are available in the OSF (https://osf.io/75eur/).
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Acknowledgements
We appreciate the hard work and critical comments of the editors and reviewers. Additionally, we thank all clinical participants for their understanding and selfless support.
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Financial support was received from the National Natural Science Foundation of China (ID: 32360206) is gratefully appreciated.
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Study design and hypothesis proposion: Fengqin Ding; Methodology and data analysis: Ning Li and Sensen Zhang; Data collection: Ning Li, Zhi Jing and Yumeng Zhao; Writing—original draft preparation: Fengqin Ding and Ning Li; Writing—review and editing: Fengqin Ding, Ning Li and Jia Li.
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This study was performed in line with the principles of the Declaration of Helsinki.Approval was granted by the Ethics Committee of Ningxia Mental Health Center (Ningan Hospital) in China (2023-WS-007).
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Ding, F., Li, N., Zhang, S. et al. Network comparison analysis of comorbid depression and anxiety disorder in a large clinical sample before and after treatment. Curr Psychol 43, 13267–13278 (2024). https://doi.org/10.1007/s12144-023-05308-3
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DOI: https://doi.org/10.1007/s12144-023-05308-3