Department of Rehabilitation Medicine, China Emergency General Hospital, Beijing, China.
Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macau, Macao SAR, China.
Front Public Health. 2024 Jul 3;12:1348870. doi: 10.3389/fpubh.2024.1348870. eCollection 2024.
Research on the mental health and quality of life (hereafter QOL) among fire service recruits after the end of the COVID-19 restrictions is lacking. This study explored the network structure of depression, anxiety and insomnia, and their interconnections with QOL among fire service recruits in the post-COVID-19 era.
This cross-sectional study used a consecutive sampling of fire service recruits across China. We measured the severity of depression, anxiety and insomnia symptoms, and overall QOL using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), Insomnia Severity Index (ISI) questionnaire, and World Health Organization Quality of Life-brief version (WHOQOL-BREF), respectively. We estimated the most central symptoms using the centrality index of expected influence (EI), and the symptoms connecting depression, anxiety and insomnia symptoms using bridge EI.
In total, 1,560 fire service recruits participated in the study. The prevalence of depression (PHQ-9 ≥ 5) was 15.2% (95% CI: 13.5-17.1%), while the prevalence of anxiety (GAD-7 ≥ 5) was 11.2% (95% CI: 9.6-12.8%). GAD4 ("Trouble relaxing") had the highest EI in the whole network model, followed by ISI5 ("Interference with daytime functioning") and GAD6 ("Irritability"). In contrast, PHQ4 ("Fatigue") had the highest bridge EI values in the network, followed by GAD4 ("Trouble relaxing") and ISI5 ("Interference with daytime functioning"). Additionally, ISI4 "Sleep dissatisfaction" (average edge weight = -1.335), which was the central symptom with the highest intensity value, had the strongest negative correlation with QOL.
Depression and anxiety were important mental health issues to address among fire service recruits in the post-COVID-19 era in China. Targeting central and bridge symptoms identified in network analysis could help address depression and anxiety among fire service recruits in the post-COVID-19 era.
目前缺乏关于新冠疫情限制结束后消防新兵心理健康和生活质量（以下简称 QOL）的研究。本研究旨在探讨新冠疫情后消防新兵的抑郁、焦虑和失眠网络结构及其与 QOL 的相互关系。
本横断面研究采用整群抽样的方法，选取了中国各地的消防新兵。我们使用 9 项患者健康问卷（PHQ-9）、7 项广泛性焦虑障碍量表（GAD-7）、失眠严重程度指数（ISI）问卷和世界卫生组织生活质量简表（WHOQOL-BREF）分别测量抑郁、焦虑和失眠症状的严重程度以及整体 QOL。我们使用预期影响中心度指数（EI）估计最中心症状，使用桥接 EI 估计连接抑郁、焦虑和失眠症状的症状。
共有 1560 名消防新兵参与了研究。抑郁（PHQ-9≥5）的患病率为 15.2%（95%可信区间：13.5-17.1%），焦虑（GAD-7≥5）的患病率为 11.2%（95%可信区间：9.6-12.8%）。整体网络模型中，GAD4（“难以放松”）的 EI 最高，其次是 ISI5（“日间功能障碍”）和 GAD6（“易怒”）。相反，网络中 PHQ4（“疲劳”）的桥接 EI 值最高，其次是 GAD4（“难以放松”）和 ISI5（“日间功能障碍”）。此外，ISI4“睡眠不满意”（平均边缘权重=-1.335）作为强度值最高的中心症状，与 QOL 呈最强的负相关。
在中国新冠疫情后时代，抑郁和焦虑是消防新兵心理健康的重要问题。针对网络分析中确定的中心和桥接症状，可能有助于解决新冠疫情后消防新兵的抑郁和焦虑问题。
