Post-pandemic changes in anxiety and depression symptom networks among socioeconomically disadvantaged young Adults: A repeated cross-sectional study.

BACKGROUND

The COVID-19 pandemic has significantly affected the mental health of young adults, particularly those facing socioeconomic hardship. Although psychological distress appears to be declining in the general population post-pandemic, vulnerable subgroups remain at elevated risk. Network analysis offers a transdiagnostic approach to understanding the dynamic interplay of depressive and anxiety symptoms over time.

METHODS

We conducted a repeated cross-sectional study among socioeconomically disadvantaged young adults in 2020 (T1) and 2024-2025 (T2). Depressive and anxiety symptoms were assessed using the PHQ-9 and GAD-7. Symptom networks were estimated using Gaussian Graphical Models with EBICglasso. The Network Comparison Test (NCT) evaluated changes in network structure and symptom centrality. Clustering analysis was performed to explore the reorganization of symptom groupings over time.

RESULTS

Mean scores increased significantly between T1 (n = 960) and T2 (n = 380) for both depression (PHQ-9: 9.43 to 11.35,  < 0.001) and anxiety (GAD-7: 6.3 to 8.14,  < 0.001). Suicidal ideation nearly doubled (25.9 %-42.9 %,  < 0.001). Network analysis revealed stronger interconnections between depressive and anxiety symptoms at T2. Anxiety symptoms (particularly GAD3, GAD2, and GAD1) became more central, while suicidal ideation shifted from a depression-specific cluster to one integrating anxiety symptoms. Clustering analysis supported a progressive integration of depressive and anxiety domains.

CONCLUSION

Our findings suggest an evolving post-pandemic psychopathological network, with anxiety symptoms becoming increasingly central and closely linked to suicidal ideation. These results underscore the need for targeted interventions addressing both depression and anxiety, particularly among socioeconomically vulnerable young adults, to more effectively reduce suicide risk in this population.