CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 101408, China.
Department of Special Education and Psychology, China National Academy of Educational Sciences, Beijing, 100088, China.
J Psychiatr Res. 2024 Nov;179:300-305. doi: 10.1016/j.jpsychires.2024.09.024. Epub 2024 Sep 20.
Gender differences have been identified in the co-occurrence of anxiety and depressive symptoms. However, the underlying mechanisms that give rise to this gender difference remain unclear, and few studies have examined the issue at the symptom level. The current study employed the 7-item Generalized Anxiety Disorder scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) to assess anxiety and depressive symptoms in a national sample of early adolescents (N = 15 391). A network approach was applied to investigate the gender differences in symptom interconnectivity. Gender differences were found in the co-occurrence of anxiety and depressive symptoms. The results indicated that girls with higher global strength (p < 0.01) exhibited stronger interconnectivity between symptoms. Central symptom PHQ2 (Sad mood) was significantly stronger in girls (p < 0.01), whereas PHQ6 (Guilt) was stronger in boys (p < 0.05). GAD7 (Feeling afraid) was identified as a prominent bridge symptom in girls, while PHQ6 (Guilt) was observed to play a similar role in boys. The directed acyclic graphs (DAGs) demonstrated that one symptom of anxiety triggered a series of emotional symptoms of anxiety and depression, ultimately resulting in a depressive somatic symptom in girls, whereas leading to both depressive somatic and anxiety symptoms in boys. These findings enhance our understanding and provide insights into potential intervention targets to prevent the co-occurrence of anxiety and depressive symptoms at an early stage.
性别差异在焦虑和抑郁症状的同时出现中已被确定。然而，导致这种性别差异的潜在机制尚不清楚，并且很少有研究在症状层面上研究这个问题。本研究采用 7 项广泛性焦虑障碍量表（GAD-7）和 9 项患者健康问卷（PHQ-9）在全国范围内的早期青少年样本中评估焦虑和抑郁症状（N=15391）。采用网络方法研究症状相互关系中的性别差异。在焦虑和抑郁症状的同时出现中发现了性别差异。结果表明，全球强度较高的女孩（p<0.01）表现出症状之间更强的相互连接性。女孩的中心症状 PHQ2（悲伤情绪）明显更强（p<0.01），而男孩的 PHQ6（内疚感）更强（p<0.05）。GAD7（感到害怕）被确定为女孩的突出桥接症状，而 PHQ6（内疚感）在男孩中也表现出类似的作用。有向无环图（DAG）表明，一种焦虑症状引发了一系列焦虑和抑郁的情绪症状，最终导致女孩出现抑郁躯体症状，而男孩则出现抑郁躯体症状和焦虑症状。这些发现增强了我们的理解，并为早期预防焦虑和抑郁症状的同时出现提供了潜在的干预目标。
