Ge Fenfen, Jiang Jingwen, Wang Yue, Wan Mentong, Zhang Wei
Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
Front Psychiatry. 2021 May 19;12:595418. doi: 10.3389/fpsyt.2021.595418. eCollection 2021.
Patients with major depressive disorder (MDD) often present with co-occurring anxiety symptoms. The network method provides a novel view on understanding the co-occurrence of depressive and anxiety symptoms. Thus, the purpose of our study was to explore it by applying network analysis methods. We used electronic medical records from West China Hospital in China. In total, 3,424 patients who met the criteria for MDD were included. R-studio 3.6 was used to estimate the network structure. First, we estimated the network structure of depression and anxiety symptoms using the graphic LASSO algorithm. Then, we estimated the centrality indices of nodes to determine which symptoms are more central in the network. We then estimated the bridge centrality indices using the function via the R package . Some strong connections were found like "easy to wake up," "wake up early," and "difficulty falling asleep," "suicidal thoughts," and "hopelessness." "Depressed mood," "somatic anxiety," "hopelessness," "anxiety mood," and "tension" have the higher centrality indices. Results revealed eight bridge symptoms (e.g., concentration/memory difficulty, gastrointestinal symptoms) in the co-occurrence network structure. This research suggests that the described approach in mapping the presence of anxiety symptoms in individuals with major depression might potentially increase diagnostic precision and help choose more targeted interventions and potentially reduce the occurrence of treatment resistance.
重度抑郁症（MDD）患者常伴有焦虑症状。网络方法为理解抑郁和焦虑症状的共现提供了新视角。因此，我们研究的目的是通过应用网络分析方法来探索这一现象。我们使用了中国华西医院的电子病历。总共纳入了3424名符合MDD标准的患者。使用R-studio 3.6估计网络结构。首先，我们使用图形套索算法估计抑郁和焦虑症状的网络结构。然后，我们估计节点的中心性指标，以确定哪些症状在网络中更核心。接着，我们通过R包中的函数估计桥接中心性指标。发现了一些强关联，如“易醒”“早醒”与“入睡困难”、“自杀念头”与“绝望”。“情绪低落”“躯体焦虑”“绝望”“焦虑情绪”和“紧张”具有较高的中心性指标。结果在共现网络结构中揭示了八个桥接症状（如注意力/记忆力困难、胃肠道症状）。这项研究表明，所描述的描绘重度抑郁症患者焦虑症状存在情况的方法可能会提高诊断准确性，并有助于选择更有针对性的干预措施，还可能减少治疗抵抗的发生。
