新冠疫情高峰期青少年抑郁和焦虑症状的网络分析
Network analysis of depressive and anxiety symptoms in adolescents during and after the COVID-19 outbreak peak.
机构信息
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China; Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
出版信息
J Affect Disord. 2022 Mar 15;301:463-471. doi: 10.1016/j.jad.2021.12.137. Epub 2022 Jan 4.
BACKGROUND
This study examined the extent to which the network structure of anxiety and depression among adolescents identified during the peak of the COVID-19 pandemic could be cross-validated in a sample of adolescents assessed after the COVID-19 peak.
METHODS
Two cross-sectional surveys were conducted between February 20 and 27, 2020 and between April 11 and 19, 2020, respectively. Depressive and anxiety symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression and 7-item Generalized Anxiety Disorder, respectively. Anxiety-depression networks of the first and second assessments were estimated separately using a sparse Graphical Gaussian Model combined with the graphical least absolute shrinkage and selection operator method. A Network Comparison Test was conducted to assess differences between the two networks.
RESULTS
The most central symptoms in the first and second survey networks were Depressed affect and Nervousness. Compared with connections in the first survey network, connections in the second survey network analysis between Relax-Nervousness-Depressed affect-Interpersonal problems (diff, contrast: second survey-first survey. diff=-0.04, P = 0.04; diff=-0.03, P = 0.03; diff=-0.03, P = 0.04), and Irritability-Somatic complaints (diff=-0.04, P = 0.02) were weaker while connections of Somatic complaints-Nervousness (diff=0.05, P<0.001), Somatic complaints-Depressed affect (diff=0.03, P = 0.009), and Irritability-Control worry-Restlessness (diff=0.02, P = 0.03; diff=0.05, P = 0.02) were stronger.
CONCLUSIONS
Depressed affect emerged as a robust central symptom and bridge symptom across Anxiety-Depression networks. Considering the negative impact of depression and anxiety on daily life, timely interventions targeting depressed affect should be implemented to reduce the co-occurrence of anxious and depressive symptoms among adolescents during the COVID-19 pandemic.
背景
本研究旨在检验在 COVID-19 大流行高峰期识别的青少年焦虑和抑郁网络结构，在 COVID-19 高峰期后评估的青少年样本中是否具有交叉验证的程度。
方法
分别于 2020 年 2 月 20 日至 27 日和 2020 年 4 月 11 日至 19 日进行了两次横断面调查。抑郁和焦虑症状分别使用 20 项中心流行病学研究抑郁和 7 项一般焦虑障碍评估。分别使用稀疏图高斯模型结合图最小绝对收缩和选择算子方法来估计第一和第二评估的焦虑 - 抑郁网络。进行网络比较测试以评估两个网络之间的差异。
结果
在第一个和第二个调查网络中，最核心的症状是抑郁情绪和神经质。与第一调查网络中的连接相比，第二调查网络分析中的连接 Relax-Nervousness-Depressed affect-Interpersonal problems（差异，对比：第二调查-第一调查，差异=-0.04，P=0.04；差异=-0.03，P=0.03；差异=-0.03，P=0.04），以及易怒 - 躯体抱怨（差异=-0.04，P=0.02）较弱，而躯体抱怨 - 神经质（差异=0.05，P<0.001），躯体抱怨 - 抑郁情绪（差异=0.03，P=0.009）和易怒 - 控制担忧 - 不安（差异=0.02，P=0.03；差异=0.05，P=0.02）更强。
结论
抑郁情绪作为一个稳健的核心症状和焦虑 - 抑郁网络中的桥梁症状出现。考虑到抑郁和焦虑对日常生活的负面影响，应针对抑郁情绪及时实施干预措施，以减少 COVID-19 大流行期间青少年焦虑和抑郁症状的同时发生。
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