Centrality depression-anxiety symptoms linked to suicidal ideation among depressed college students--A network approach.

The long-term effects of the COVID-19 pandemic have caused severe mental health problems among college students, which can eventually cause suicidal ideation. Therefore, through network analysis, this study aims to explore the new characteristics of the depression-anxiety symptom network that arose during the long-term lockdown of the COVID-19 pandemic and to identify the most influential symptoms linked to suicidal ideation. We used a Patient Health Questionnaire (PHQ-9) score above 10 as the cutoff and screened 622 participants with an inclination toward depressive disorders from 7976 college students, and then divided the sample into suicidal and nonsuicidal groups based on the presence or absence of suicidal ideation. The General Anxiety Disorder scale (GAD-7) was also used. Network analysis was used to identify the network structure of anxiety-depression and which symptoms were directly related to suicidal ideation in the network. The prevalence of depression and anxiety among Chinese college students in the late stage of the COVID-19 pandemic was 7.8% and 17.8%, respectively. The most central symptoms in the nonsuicidal group were "excessive worry," "uncontrollable worry," and "nervousness," and in the suicidal group they were "excessive worry," "motor function," and "irritability." The network of the suicidal group was denser than that of the nonsuicidal group. The most influential symptom directly related to suicidal ideation was "guilt." The most influential central symptom of depression-anxiety comorbidity characteristics of Chinese adolescents showed a tendency to shift from depression-oriented (i.e., sad mood) to anxiety-oriented (i.e., excessive worry) with the continuation of the COVID-19 pandemic. Treatments or interventions focused on these critical symptoms could be useful in preventing college students from suicide risk.